Journal of Cancer Research and Clinical Oncology

, Volume 143, Issue 2, pp 313–320 | Cite as

The recommended treatment strategy for locally advanced gastric cancer in elderly patients aged 75 years and older: a Surveillance, Epidemiology, and End Results database analysis

  • Kai-tai Liu
  • Jue-feng Wan
  • Gen-hua Yu
  • Yan-ping Bei
  • Xue Chen
  • Miao-zhen Lu
Original Article – Clinical Oncology
First Online:
Received:
Accepted:

Background

As patients aged 75 years and older are often underrepresented in randomized clinical trials, the external validity of clinical trials-based recommendations in older gastric patients was still controversial. The aim of this study is to explore the recommended treatment strategy for locally advanced gastric cancer in elderly patients.

Methods

We designed our study to specifically evaluate the cancer-specific survival (CSS) of four subgroups of patients according to four different treatment modalities: adjuvant radiation (RT), surgery only, RT only and no surgery/no RT by analyzing the Surveillance, Epidemiology, and End Results (SEER)-registered database. Kaplan–Meier methods were adopted and multivariable Cox regression models were built for the analysis of survival outcomes and risk factors.

Results

The 5-year CSS was 43.8 % in adjuvant RT, 28.5 % in surgery only, 14.9 % in RT only and 1.4 % in no surgery/no RT, which had significant difference in univariate log-rank test (P < 0.001) and multivariate Cox regression (P < 0.001). Moreover, we observed significant survival benefits in adjuvant RT group in all age categories, including age 75–79 years, age 80–84 years and age ≥85 years (all P < 0.001).

Conclusions

Surgery and adjuvant RT may be the recommended treatment strategy in elderly patients with locally advanced gastric cancer, especially for patients medically fit for the combined modality therapy.

Keywords

Gastric cancer Elderly Treatment SEER 
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Notes

Acknowledgments

The authors acknowledge the efforts of the Surveillance, Epidemiology, and End Results (SEER) program tumor registries in the creation of the SEER database. The interpretation and reporting of these data are the sole responsibility of the authors.

Author contributions

KTL, JFW and GHY conceived of and designed the study. KTL, JFW and YPB performed the analyses. GHY and XC prepared all tables. KTL and MZL wrote the main manuscript. All authors reviewed the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Kai-tai Liu
    • 1
  • Jue-feng Wan
    • 2
    • 3
  • Gen-hua Yu
    • 4
  • Yan-ping Bei
    • 1
  • Xue Chen
    • 1
  • Miao-zhen Lu
    • 1
  1. 1.Department of Radiation Oncology, Lihuili HospitalNingbo Medical CenterNingboChina
  2. 2.Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
  3. 3.Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
  4. 4.Department of Radiation OncologyHuzhou Central HospitalHuzhouChina

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