Nikolaos Charalampakis1, Lianchun Xiao2, Quan Lin1, Elena Elimova1, Yusuke Shimodaira1, Kazuto Harada1, Jane E Rogers3, Jeannette Mares1, Fatemeh G Amlashi1, Bruce D Minsky4, Prajnan Das4, Wayne L Hofstetter5, Aurelio Matamoros6, Tara L Sagebiel6, Mariela A Blum-Murphy1, Jeffrey H Lee7, Brian Weston7, Manoop S Bhutani7, Paul F Mansfield8, Jeannelyn S Estrella9, Brian D Badgwell8, Jaffer A Ajani10. 1. Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center (UTMDACC), Houston, TX, USA. 2. Department of Biostatistics, The University of Texas M.D. Anderson Cancer, Houston, TX, USA. 3. Department of Pharmacy Clinical Programs, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. 4. Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center U. T. M. D. Anderson Cancer Center, Houston, TX, USA. 5. Department of Thoracic and Cardiovascular Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. 6. Department of Radiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. 7. Department of Gastroenterology, The University of Texas M. D. Anderson Cancer Center U. T. M. D. Anderson Cancer Center, Houston, TX, USA. 8. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. 9. Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. 10. Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center (UTMDACC), Houston, TX, USA. jajani@mdanderson.org.
Abstract
BACKGROUND: Older patients with localized gastric adenocarcinoma (LGAC) have substantial postoperative morbidity and mortality; however, postoperative outcomes of the patients who receive preoperative chemotherapy and/or chemoradiation have not been reported. We examined the impact of age at baseline on potential predictors of postoperative outcomes. METHODS: Patients with LGAC who were treated with chemotherapy and/or chemoradiation followed by surgery (n = 203) formed two groups: (1) ≥65 years old (n = 70) and (2) <65 years old (n = 133). We assessed postoperative morbidity and mortality as well as overall survival (OS) and progression-free survival (PFS). Potential predictors of 90-day postoperative outcomes were identified i) by age groups and ii) other clinical covariates. Descriptive statistics and survival analyses were utilized. RESULTS: 90-day postoperative morbidity was similar in older and younger patients (61 % vs 58 %; P = 0.655). 90-day mortality was similar (3 % vs 0 %; P = 0.118). Major Clavien grade III/IV complications were similar (17 % vs 12 %; P = 0.392). OS and PFS were also similar for both groups (P = 0.863 and P = 0.558, respectively). Other factors, such as Charlson comorbidity index (P < 0.001) and median operative time (P = 0.002) were strongly associated with postoperative complications. CONCLUSION: Our data show that older patients with LGAC generally have similar outcomes as do younger patients after preoperative therapy but comorbidity indices have significant impact on complications and the long-term outcomes rather than age.
BACKGROUND: Older patients with localized gastric adenocarcinoma (LGAC) have substantial postoperative morbidity and mortality; however, postoperative outcomes of the patients who receive preoperative chemotherapy and/or chemoradiation have not been reported. We examined the impact of age at baseline on potential predictors of postoperative outcomes. METHODS:Patients with LGAC who were treated with chemotherapy and/or chemoradiation followed by surgery (n = 203) formed two groups: (1) ≥65 years old (n = 70) and (2) <65 years old (n = 133). We assessed postoperative morbidity and mortality as well as overall survival (OS) and progression-free survival (PFS). Potential predictors of 90-day postoperative outcomes were identified i) by age groups and ii) other clinical covariates. Descriptive statistics and survival analyses were utilized. RESULTS: 90-day postoperative morbidity was similar in older and younger patients (61 % vs 58 %; P = 0.655). 90-day mortality was similar (3 % vs 0 %; P = 0.118). Major Clavien grade III/IV complications were similar (17 % vs 12 %; P = 0.392). OS and PFS were also similar for both groups (P = 0.863 and P = 0.558, respectively). Other factors, such as Charlson comorbidity index (P < 0.001) and median operative time (P = 0.002) were strongly associated with postoperative complications. CONCLUSION: Our data show that older patients with LGAC generally have similar outcomes as do younger patients after preoperative therapy but comorbidity indices have significant impact on complications and the long-term outcomes rather than age.
Authors: Natalie Liu; Daniela Molena; Miloslawa Stem; Amanda L Blackford; David B Sewell; Anne O Lidor Journal: J Gastrointest Surg Date: 2018-02-05 Impact factor: 3.452
Authors: A Natori; B A Chan; H W Sim; L Ma; D W Yokom; E Chen; G Liu; G Darling; C Swallow; S Brar; J Brierley; J Ringash; R Wong; J Kim; P Rogalla; S Hafezi-Bakhtiari; J Conner; J Knox; E Elimova; R W Jang Journal: Curr Oncol Date: 2018-12-01 Impact factor: 3.677
Authors: Natalie Liu; Yiwei Xu; Amir A Rahnemai-Azar; Daniel E Abbott; Sharon M Weber; Anne O Lidor Journal: J Gastrointest Surg Date: 2019-12-02 Impact factor: 3.452