Characteristics and prognosis of gastric cancer in patients aged ≥ 70 years

Table 1 Case characteristics n (%)

Characteristics	Age (yr)			χ2	P value
	< 50 (n = 166)	50-69 (n = 481)	≥70 (n = 273)
Age (mean ± SD)	42.8 ± 5.8	60.1 ± 5.5	74.1 ± 3.4
Gender				32.504	< 0.001
Female	76 (45.8)	127 (26.4)	58 (21.2)
Male	90 (54.2)	354 (73.6)	215 (78.8)
Tumor location				39.900	< 0.001
Lower 1/3	83 (50.0)	201 (41.8)	88 (40.4)
Middle 1/3	31 (18.7)	87 (18.1)	48 (17.6)
Upper 1/3	21 (12.7)	143 (29.7)	106 (38.8)
2/3 or more	31 (18.7)	50 (10.4)	31 (11.4)
Tumor location				34.186	< 0.001
Upper 1/3	21 (12.7)	143 (29.7)	106 (38.8)
Non-upper 1/3	145 (87.3)	338 (70.3)	167 (61.2)
Tumor size				13.589	0.001
< 5 cm	79 (47.6)	209 (43.5)	87 (31.9)
≥ 5 cm	87 (52.4)	272 (56.5)	186 (68.1)
Tumor size, cm (mean ± SD)	5.640 ± 3.172	5.552 ± 2.810	6.304 ± 3.644	5.035	0.007
Borrmann type				2.443	0.296
I/II	47 (28.3)	166 (34.5)	95 (34.8)
III/IV	119 (71.7)	315 (65.5)	178 (65.2)
Histology				39.366	< 0.001
Differentiated	24 (14.5)	139 (28.9)	116 (42.5)
Undifferentiated	142 (85.5)	342 (71.1)	157 (57.5)
Extranodal metastasis				4.733	0.094
Negative	121 (72.9)	378 (78.6)	223 (81.7)
Positive	45 (27.1)	103 (21.4)	50 (18.3)
Surgical margin status				2.873	0.238
Negative	137 (82.5)	415 (86.3)	241 (88.3)
Positive	29 (17.5)	66 (13.7)	32 (11.7)
Depth of invasion				5.457	0.487
pT1	4 (2.4)	12 (2.5)	6 (2.2)
pT2	22 (13.3)	49 (10.2)	22 (8.1)
pT3	5 (3.0)	30 (6.2)	17 (6.2)
pT4	135 (81.3)	390 (81.1)	228 (83.5)
Lymph node metastasis				5.325	0.503
pN0	62 (37.3)	170 (35.5)	87 (31.9)
pN1	26 (15.7)	83 (17.3)	51 (18.7)
pN2	32 (19.3)	108 (22.5)	73 (26.7)
pN3	46 (27.7)	120 (24.9)	62 (22.7)
Distant metastasis				9.251	0.010
M0	149 (89.8)	442 (91.9)	264 (96.7)
M1	17 (10.2)	39 (8.1)	9 (3.3)
Types of distant metastasis				5.502	0.240
Liver metastasis	5 (29.4)	19 (48.7)	5 (55.6)
Peritoneal metastasis	12 (70.6)	18 (46.2)	3 (33.3)
Other distant metastasis	0 (0.0)	2 (5.1)	1 (11.1)
TNM stage				13.270	0.039
I	19 (11.4)	43 (8.9)	21 (7.7)
II	45 (27.1)	135 (28.1)	72 (26.4)
III	85 (51.2)	264 (54.9)	171 (62.6)
IV	17 (10.2)	39 (8.1)	9 (3.3)
Chemotherapy				48.852	< 0.001
Yes	71 (42.8)	142 (29.5)	36 (13.2)
No	95 (57.2)	339 (70.5)	237 (86.8)
Type of gastrectomy				7.466	0.024
Subtotal	112 (67.5)	361 (75.1)	216 (79.1)
Total	54 (32.5)	120 (24.9)	57 (20.9)
Extent of lymphadenectomy				19.735	< 0.001
D2	89 (53.6)	222 (46.2)	91 (33.3)
D1	77 (46.4)	259 (53.8)	182 (66.7)

Table 2 Survival analysis of all patients with gastric cancer after surgery

Characteristics	n (%)	5-yr OS	MST (mo)	Univariate analysis		Multivariate analysis
				χ2	P (log-rank)	Hazard ratio (95%CI)	P value
Gender				0.165	0.685
Male	659 (71.6)	32.00%	26
Female	261 (28.4)	33.70%	27
Age (yr)				21.067	< 0.000
< 50	166 (18.0)	38.00%	32			1 (ref)
50-69	481 (52.3)	36.60%	28			1.107 (0.881, 1.391)	0.383
≥ 70	273 (29.7)	22.00%	20			1.487 (1.149, 1.924)	0.003
Tumor location				37.996	< 0.001
Lower 1/3	372 (40.4)	40.10%	36			1 (ref)
Middle 1/3	166 (18.0)	30.10%	18			1.129 (0.881, 1.446)	0.339
Upper 1/3	270 (29.3)	29.60%	25			1.063 (0.864, 1.309)	0.564
2/3 or more	112 (12.2)	17.90%	16			1.311 (0.985, 1.744)	0.064
Tumor size				51.052	< 0.001
< 5 cm	375 (40.8)	45.10%	42			1 (ref)
≥ 5 cm	545 (59.2)	23.90%	20			1.185 (0.994, 1.413)	0.058
Borrmann type				9.588	0.002
I/II	308 (33.5)	38.30%	33			1 (ref)
III/IV	612 (66.5)	29.60%	23			1.171 (0.980, 1.399)	0.082
Histology				13.994	< 0.001
Differentiated	279 (30.3)	41.20%	34			1 (ref)
Undifferentiated	641 (69.7)	28.70%	23			1.201 (0.996, 1.449)	0.055
Extranodal metastasis				61.626	< 0.001
Negative	722 (78.5)	37.10%	31			1 (ref)
Positive	198 (21.5)	15.70%	15			1.164 (0.962, 1.409)	0.119
Surgical margin status				101.241	< 0.001
Negative	793 (86.2)	36.70%	31			1 (ref)
Positive	127 (13.8)	6.30%	11			1.705 (1.357, 2.142)	< 0.001
Depth of invasion				67.084	< 0.001
pT1	22 (2.4)	86.40%	69			1 (ref)
pT2	93 (10.1)	61.30%	61			3.048 (0.937, 9.918)	0.064
pT3	52 (5.7)	46.20%	47			3.188 (0.965, 10.526)	0.057
pT4	753 (81.8)	26.40%	21			4.580 (1.431, 14.200)	0.010
Lymph node metastasis				243.605	< 0.001
pN0	319 (34.7)	57.70%				1 (ref)
pN1	160 (17.4)	31.90%	24			1.713 (1.327, 2.211)	< 0.001
pN2	213 (23.2)	23.50%	23			1.918 (1.514, 2.429)	< 0.001
pN3	228 (24.8)	6.10%	13			3.268 (2.572, 4.151)	< 0.001
Distant metastasis				89.428	< 0.001
M0	855 (92.9)	34.70%	29			1 (ref)
M1	65 (7.1)	3.10%	8			1.817 (1.339, 2.465)	< 0.001
Chemotherapy				17.080	< 0.001
Yes	249 (27.1)	39.80%	37			1 (ref)
No	671 (72.9)	29.80%	22			1.383 (1.144, 1.673)	0.001
Type of gastrectomy				40.899	< 0.001
Subtotal	689 (73.9)	36.90%	31			1 (ref)
Total	231 (26.1)	19.50%	16			1.170 (0.944, 1.450)	0.151
Extent of lymphadenectomy				4.060	0.044
D2	402 (43.7)	36.60%	28			1 (ref)
D1	518 (56.3)	29.30%	24			1.192 (1.005, 1.414)	0.043

Ref: Reference category; OS: Overall survival; MST: Median survival time.

Table 3 Survival analysis of younger, middle-aged and elderly patients stratified by tumor-node-metastasis stage

TNM	Younger (< 50 yr)			Middle-aged (50-69 yr)			Elderly (≥70 yr)			χ2	P value
	n	5-yr OS	MST (mo)	n	5-yr OS	MST (mo)	n	5-yr OS	MST (mo)
I	19	78.90%	68	43	81.40%	64	21	66.70%	66	1.200	0.594
II	45	53.30%	60	135	60.00%	61	72	33.30%	39	13.024	0.001
III	85	27.10%	24	264	22.30%	20	171	12.90%	16	11.874	0.003
IV	17	5.90%	10	39	2.60%	8	9	0.00%	6	2.909	0.233

MST: Median survival time; TNM: Tumor-node-metastasis; OS: Overall survival.

Table 4 Survival analysis of gastric cancer patients aged ≥ 70 years

Characteristics	n (%)	5-yr OS	MST (mo)	Univariate analysis		Multivariate analysis
				χ2	P (log-rank)	Hazard ratio (95%CI)	P value
Gender				4.009	0.045
Female	58 (21.2)	29.30%	31			1 (ref)
Male	215 (78.8)	20.00%	18			1.433 (1.013, 2.029)	0.042
Age (yr)				0.092	0.762
< 75	164 (60.1)	23.20%	20
≥ 75	109 (39.9)	20.20%	19
Tumor location				6.055	0.109
Lower 1/3	78 (28.6)	25.60%	22
Middle 1/3	58 (21.2)	22.40%	15
Upper 1/3	106 (38.8)	21.70%	22
2/3 or more	31 (11.4)	12.90%	16
Tumor size				8.715	0.003
< 5 cm	87 (31.9)	32.20%	31			1 (ref)
≥ 5 cm	186 (68.1)	17.20%	17			1.119 (0.816, 1.533)	0.485
Borrmann type				3.221	0.073
I/II	95 (34.8)	27.40%	26
III/IV	178 (65.2)	19.10%	18
Histology				5.610	0.018
Differentiated	116 (42.5)	28.40%	23			1 (ref)
Undifferentiated	157 (57.5)	17.20%	18			1.272 (0.956, 1.693)	0.099
Extranodal metastasis				16.966	< 0.001
Negative	223 (81.7)	24.70%	23			1 (ref)
Positive	45 (18.3)	10.00%	11			1.248 (0.873, 1.784)	0.225
Surgical margin status				8.957	0.003
Negative	241 (88.3)	24.10%	22			1 (ref)
Positive	32 (11.7)	6.30%	12			1.583 (1.048, 2.391)	0.029
Depth of invasion				20.751	< 0.001
pT1-T3	45 (16.5)	51.10%	65			1 (ref)
pT4	228 (83.5)	16.20%	17			1.773 (1.118, 2.811)	0.015
Lymph node metastasis				30.397	< 0.001
pN0	87 (31.9)	40.20%	44			1 (ref)
pT1-N3	186 (68.1)	13.40%	16			1.658 (1.178, 2.334)	0.004
Distant metastasis				18.941	< 0.001
M0	264 (96.7)	22.70%	21			2.332 (1.143, 4.756)	0.020
M1	9 (3.3)	0.00%	6
Chemotherapy				0.508	0.476
Yes	36 (13.2)	13.90%	20
No	237 (86.8)	23.20%	20
Type of gastrectomy				11.316	0.001
Subtotal	214 (78.4)	24.80%	22			1 (ref)
Total	59 (21.6)	11.90%	14			1.305 (0.936, 1.820)	0.117
Extent of lymphadenectomy				1.429	0.232
D2	91 (33.3)	19.80%	17
D1	182 (66.7)	23.10%	22

Ref: Reference category; OS: Overall survival; MST: Median survival time.

Table 5 Comparison of survival rate for patients treated with chemotherapy or not stratified by age

Age (yr)	Chemotherapy						χ2	P value
	Yes			No
	n	5-yr OS	MST (mo)	n	5-yr OS	MST (mo)
< 50	71	47.90%	53	95	30.50%	23	8.774	0.003
50-69	142	42.30%	37	339	34.20%	22	7.427	0.006
≥ 70	36	13.90%	20	237	23.20%	20	0.508	0.476

OS: Overall survival; MST: Median survival time.