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Efficacy of chemotherapy for older patients with gastric cancer: a multicenter retrospective cohort study

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Abstract

Background

Gastric cancer is one of the leading causes of malignant disease-related mortality, worldwide. With the use of recently developed anti-tumor agents, the prognoses of patients with unresectable gastric cancer are improving. However, the development of an aggressive treatment strategy for older patients (OPs) remains under debate due to concerns regarding treatment feasibility or patient frailty. We aimed to elucidate whether aggressive chemotherapy has survival benefits for OPs with advanced gastric cancer.

Methods

We analyzed consecutive patients diagnosed with inoperable advanced gastric cancer across seven hospitals from August 2007 to July 2015. We defined OPs as patients aged 75 years or older and compared their survival rates with those of non-older patients (NPs).

Results

A total of 256 OPs and 425 NPs were enrolled. Of the OPs, 152 patients received chemotherapy and 104 patients received best supportive care (BSC). In contrast, among the NPs, 375 patients received chemotherapy and 50 patients received BSC. There was no significant difference of the median survival time between OPs and NPs in the response to BSC (61 vs 43 days) or chemotherapy (312 vs 348 days). Combination chemotherapy significantly improved survival compared to monotherapy in both OPs and NPs groups (382 vs 253 days in OPs, 381 vs 209 days in NPs). Good performance status, combination therapy, and male, but not age, were significant independent prognostic factors.

Conclusion

When the performance status of a gastric cancer patient is good, active chemotherapy may improve survival, regardless of age.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, 565-0871, Osaka, Japan

    Yoshito Hayashi, Yoshiki Tsujii, Hideki Iijima & Tetsuo Takehara

  2. Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Japan

    Tsutomu Nishida & Aya Sugimoto

  3. Department of Gastroenterology, Itami City Hospital, Itami, Japan

    Shusaku Tsutsui

  4. Department of Gastroenterology, Kansai Rosai Hospital, Amagasaki, Japan

    Takashi Ohta, Shinjiro Yamaguchi & Hideki Hagiwara

  5. Department of Gastroenterology, Saiseikai Senri Hospital, Suita, Japan

    Masayoshi Horimoto & Kunio Suzuki

  6. Department of Gastroenterology, National Hospital Organization Osaka Minami National Hospital, Kawachinagano, Japan

    Eiji Masuda

  7. Department of Gastroenterology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan

    Hiroyuki Narahara

Authors
  1. Yoshito Hayashi
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  2. Tsutomu Nishida
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  3. Shusaku Tsutsui
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  4. Takashi Ohta
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  7. Eiji Masuda
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  8. Hiroyuki Narahara
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  9. Aya Sugimoto
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  10. Yoshiki Tsujii
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  13. Hideki Iijima
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  14. Tetsuo Takehara
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Correspondence to Tetsuo Takehara.

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Hayashi, Y., Nishida, T., Tsutsui, S. et al. Efficacy of chemotherapy for older patients with gastric cancer: a multicenter retrospective cohort study. Int J Clin Oncol 24, 1377–1384 (2019). https://doi.org/10.1007/s10147-019-01501-2

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  • DOI: https://doi.org/10.1007/s10147-019-01501-2

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