Effect of Age on Prognosis of Gastric Signet-Ring Cell Carcinoma: A SEER Database Analysis

Abstract

BACKGROUND Age is a prognostic factor for multiple malignancies. In this study, we aimed to assess the effect of age on the cancer-specific survival (CSS) of patients with gastric signet-ring cell carcinoma (SRC). MATERIAL AND METHODS Information on patients with gastric SRC was extracted from the Surveillance, Epidemiology, and End Results database. Chi-squared tests were used to demonstrate distribution differences, and Kaplan-Meier analysis and Cox regression models were used to analyze the impact of age on CSS. RESULTS A total of 4596 patients were enrolled and divided into 3 subgroups according to age (<45, 45-74, and >74 years old). Higher percentages of T4, N2, and M1 disease were observed in the <45-year-old group (all P<0.001). Kaplan-Meier plots showed that the youngest group had the most favorable 5-year CSS rate (36.3%), which remained true after stratification according to tumor stage. Multivariate Cox regression models demonstrated a poorer survival outcome for >74-year-old than for <45-year-old patients (hazard ratio 1.841, 95% confidence interval 1.636-2.071; P<0.001). CONCLUSIONS Young age is associated with improved survival, even though younger patients generally present with a more advanced-stage disease.

Figure 1

Survival curves for patients with signet-ring cell carcinoma of the gastric according to 3 age subgroups. χ²=46.838, P<0.001.

Figure 2

Survival curves for patients with signet-ring cell carcinoma of the gastric in tumor stage subgroups. (A) Stage I: χ²=54.738, P<0.001; (B) Stage II: χ²=8.339, P=0.015; (C) Stage III: χ²=91.76, P<0.001; (D) Stage IV: χ²=32.425, P<0.001.