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

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 o...

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Bibliographic Details
Published in:International journal of clinical oncology 2019-11, Vol.24 (11), p.1377-1384
Main Authors: Hayashi, Yoshito, Nishida, Tsutomu, Tsutsui, Shusaku, Ohta, Takashi, Yamaguchi, Shinjiro, Horimoto, Masayoshi, Masuda, Eiji, Narahara, Hiroyuki, Sugimoto, Aya, Tsujii, Yoshiki, Suzuki, Kunio, Hagiwara, Hideki, Iijima, Hideki, Takehara, Tetsuo
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Cancer Research
Cancer therapies
Chemotherapy
Cohort analysis
Cohort Studies
Female
Gastric cancer
Humans
Kaplan-Meier Estimate
Male
Medical prognosis
Medicine
Medicine & Public Health
Middle Aged
Oncology
Original Article
Patients
Prognosis
Retrospective Studies
Stomach Neoplasms - drug therapy
Stomach Neoplasms - mortality
Stomach Neoplasms - pathology
Surgical Oncology
Survival
Treatment Outcome
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Summary: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.
ISSN:1341-9625
1437-7772
DOI:10.1007/s10147-019-01501-2