Clinicopathologic characteristics of gastric carcinoma in elderly patients: a comparison with young patients

Abstract

Aim: To examine the clinicopathologic features of elderly patients with gastric carcinoma and to investigate the relationship between prognosis and age.

Methods: We reviewed the hospital records of 2,014 patients with gastric carcinoma retrospectively to compare the clinicopathologic findings in elderly (age >70 years) and young (age <36 years) patients during the period from 1986 to 2000 in a tertiary referral center in Gwangju, Korea. Overall survival was the main outcome measure.

Results: Of the 2,014 patients, 194 (9.6%) were in the elderly group and 137 (6.8%) were in the young group. The elderly and young patients had similar distributions with respect to depth of invasion, nodal involvement, hepatic metastasis, peritoneal dissemination, tumor stage at the initial diagnosis, and type of surgery. Synchronous multiple carcinomas were found in 14/194 (7.2%) of the elderly group and 4/137 (2.9%) of the young group (P<0.05). Using the Borrmann classification, type IV was more frequent in the young patients than in the elderly patients (P<0.05). Significantly more elderly patients had a well or moderately differentiated histology, and more young patients had a poorly differentiated histology and signet ring cell carcinoma (P<0.001). The 5-year survival rates of elderly and young patients did not differ statistically (52.8% vs 46.5%, P = 0.5290). Multivariate analysis showed that the histologic type, nodal involvement and operative curability were significant prognostic factors, and age itself was not an independent prognostic factor of survival for elderly gastric carcinoma patients.

Conclusion: Elderly patients with gastric carcinoma do not have a worse prognosis than young patients. The important prognostic factor is whether the patients undergo a curative resection.

Figure 1

Survival curves of young and elderly patients without and with curative resection. A: Survival curves of young and elderly patients without curative resection. The 5-year survival rates of young and elderly patients did not differ statistically (52.8% vs 46.5%, P = 0.5290); B: Survival curves of the young and elderly groups with curative resection. The 5-year survival rates of young and elderly patients with curative resection did not differ statistically (67.0% vs 60.0%, P = 0.3100).

Figure 2

Survival curves of elderly patients according to resectability. The patients with curative resection had a better 5-year survival rate than those with non-curative resection in elderly group (60.0% vs 6.5%; P<0.001).