Anne Schlesinger-Raab1, André L Mihaljevic2, Silvia Egert3, Rebecca Emeny4, Karl-Walter Jauch5, Jörg Kleeff6, Alexander Novotny6, Natascha C Nüssler7, Miriam Rottmann4, Wolfgang Schepp8, Wolfgang Schmitt9, Gabriele Schubert-Fritschle4, Bernhard Weber10, Christoph Schuhmacher11, Jutta Engel4. 1. Munich Cancer Registry (MCR), Munich Tumour Centre (TZM), Department of Medical Informatics, Biometry and Epidemiology (IBE), Klinikum Großhadern, Ludwig-Maximilians-University (LMU), Marchioninistr. 15, 81377, Munich, Germany. schlesi@ibe.med.uni-muenchen.de. 2. Department of Surgery, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany. 3. Münchner Studienzentrum (MSZ), Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 4. Munich Cancer Registry (MCR), Munich Tumour Centre (TZM), Department of Medical Informatics, Biometry and Epidemiology (IBE), Klinikum Großhadern, Ludwig-Maximilians-University (LMU), Marchioninistr. 15, 81377, Munich, Germany. 5. Klinikum Großhadern, Ludwig-Maximilians-University (LMU), Munich, Germany. 6. Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany. 7. Department of Surgery, Klinikum Neuperlach, Städtisches Klinikum München, Munich, Germany. 8. Department of Gastroenterology, Hepatology and Gastrointestinal Oncology, Klinikum Bogenhausen, Städtisches Klinikum München, Munich, Germany. 9. Department of Gastroenterology, Klinikum Neuperlach, Städtisches Klinikum München, Munich, Germany. 10. Department of Internal Medicine, Klinik Bad Trissl, Oberaudorf, Germany. 11. Medical Faculty, Technische Universität München, Munich, Germany.
Abstract
BACKGROUND: Gastric cancer accounts for 5 % of cancer deaths. Proportions of older stomach cancer patients are increasing. Despite the still poor prognosis, standardised treatment has achieved improvements; nonetheless it is questionable whether all age groups have benefitted. Age and outcome need to be examined in a population-based setting. METHODS: Analyses included Munich Cancer Registry (MCR) data from 8601 invasive gastric cancer patients, diagnosed between 1998 and 2012. Tumour and therapy characteristics and outcome were analysed by two age groups (<70 vs. ≥70 years). Survival was analysed using the Kaplan-Meier method and relative survival was computed as an estimation for cancer-specific survival. Additional landmark analyses were conducted by calculating conditional survival of patients who survived more than 6 months. RESULTS: Fifty-nine per cent of the cohort were ≥70 years old. These patients had tumours with a slightly better prognosis and were treated with less radical surgery and adjuvant therapy than younger patients. The 5-year relative survival was 40 % for the youngest (<50 years) and 23 % for the oldest patients (≥80 years). Survival differences were diminished or eliminated after landmark analyses: The 5-year relative survival in age groups 50-59, 60-69 and 70-79 years was comparable (between 48 and 49.6 %) and slightly worse in the youngest and oldest (45 %), which may be explained by more aggressive tumours and effects of cellular senescence, respectively. CONCLUSION: The treatment and care of elderly gastric cancer patients in the MCR catchment area seems appropriate: if a patient's general condition allows oncologic resection and chemotherapy, it is conducted and the result is comparable between age groups.
BACKGROUND:Gastric cancer accounts for 5 % of cancer deaths. Proportions of older stomach cancerpatients are increasing. Despite the still poor prognosis, standardised treatment has achieved improvements; nonetheless it is questionable whether all age groups have benefitted. Age and outcome need to be examined in a population-based setting. METHODS: Analyses included Munich Cancer Registry (MCR) data from 8601 invasive gastric cancerpatients, diagnosed between 1998 and 2012. Tumour and therapy characteristics and outcome were analysed by two age groups (<70 vs. ≥70 years). Survival was analysed using the Kaplan-Meier method and relative survival was computed as an estimation for cancer-specific survival. Additional landmark analyses were conducted by calculating conditional survival of patients who survived more than 6 months. RESULTS: Fifty-nine per cent of the cohort were ≥70 years old. These patients had tumours with a slightly better prognosis and were treated with less radical surgery and adjuvant therapy than younger patients. The 5-year relative survival was 40 % for the youngest (<50 years) and 23 % for the oldest patients (≥80 years). Survival differences were diminished or eliminated after landmark analyses: The 5-year relative survival in age groups 50-59, 60-69 and 70-79 years was comparable (between 48 and 49.6 %) and slightly worse in the youngest and oldest (45 %), which may be explained by more aggressive tumours and effects of cellular senescence, respectively. CONCLUSION: The treatment and care of elderly gastric cancerpatients in the MCR catchment area seems appropriate: if a patient's general condition allows oncologic resection and chemotherapy, it is conducted and the result is comparable between age groups.
Entities:
Keywords:
Cancer registry; Comparative effectiveness research; Elderly; Gastric cancer; Stomach cancer
Authors: M Moehler; S-E Al-Batran; T Andus; M Anthuber; J Arends; D Arnold; D Aust; P Baier; G Baretton; J Bernhardt; H Boeing; E Böhle; C Bokemeyer; J Bornschein; W Budach; E Burmester; K Caca; W A Diemer; C F Dietrich; M Ebert; A Eickhoff; C Ell; J Fahlke; H Feussner; R Fietkau; W Fischbach; W Fleig; M Flentje; H E Gabbert; P R Galle; M Geissler; I Gockel; U Graeven; L Grenacher; S Gross; J T Hartmann; M Heike; V Heinemann; B Herbst; T Herrmann; S Höcht; R D Hofheinz; H Höfler; T Höhler; A H Hölscher; M Horneber; J Hübner; J R Izbicki; R Jakobs; C Jenssen; S Kanzler; M Keller; R Kiesslich; G Klautke; J Körber; B J Krause; C Kuhn; F Kullmann; H Lang; H Link; F Lordick; K Ludwig; M Lutz; R Mahlberg; P Malfertheiner; S Merkel; H Messmann; H-J Meyer; S Mönig; P Piso; S Pistorius; R Porschen; T Rabenstein; P Reichardt; K Ridwelski; C Röcken; I Roetzer; P Rohr; W Schepp; P M Schlag; R M Schmid; H Schmidberger; W-H Schmiegel; H-J Schmoll; G Schuch; C Schuhmacher; K Schütte; W Schwenk; M Selgrad; A Sendler; J Seraphin; T Seufferlein; M Stahl; H Stein; C Stoll; M Stuschke; A Tannapfel; R Tholen; P Thuss-Patience; K Treml; U Vanhoefer; M Vieth; H Vogelsang; D Wagner; U Wedding; A Weimann; H Wilke; C Wittekind Journal: Z Gastroenterol Date: 2011-04-07 Impact factor: 2.000
Authors: Giovanni Li Destri; Mario Cavallaro; Maria Antonietta Trovato; Francesca Ferlito; Marine Castaing; Stefano Puleo Journal: Int Surg Date: 2012 Jul-Sep