Clinicopathological features and prognosis in elderly gastric cancer patients: a retrospective cohort study.

Background: Little is known about the clinicopathological features and prognosis in elderly gastric cancer (GC) patients aged 65-79 years. The aim of this study was to evaluate clinicopathological features and prognosis in elderly GC patients.

Patients and methods: From May 2008 to December 2014, a total of 5,282 GC patients were enrolled in our present study. Patients were divided into elderly and middle-aged groups. The clinicopathological features and clinical outcomes were analyzed.

Results: The proportion of dysphagia was significantly higher in elderly patients than that in middle-aged patients ( P =0.002), whereas the proportion of abdominal pain and heartburn was significantly lower in elderly patients than that in middle-aged patients ( P <0.001 vs P =0.038, respectively). The proportion of patients with carbohydrate antigen (CA) 19-9 was significantly higher in elderly patients than that in middle-aged patients ( P =0.009). There was no significant difference in clinicopathological features between elderly and middle-aged patients with D2 gastrectomy (all P >0.05). Age, tumor size, histological type, tumor depth, lymph node metastasis, carcinoembryonic antigen, alpha fetoprotein, CA19-9, and CA125 were independent risk factors for the prognosis of GC patients in univariate and multivariate analyses. Overall survival in elderly patients was significantly reduced compared with middle-aged patients ( P =0.001), especially in patients with tumor size >5 cm ( P =0.002), poorly differentiated tumor ( P <0.000), stage III tumor ( P =0.002), or normal levels of carcinoembryonic antigen ( P =0.009), alpha fetoprotein ( P =0.002), CA19-9 ( P =0.002), and CA125 ( P =0.004).

Conclusion: The clinicopathological features of elderly patients were different to those of middle-aged patients. The prognosis for elderly GC patients was significantly worse than for middle-aged patients.