Effect of age on rates of palliative surgery and chemotherapy use in patients with locally advanced or metastatic gastric cancer. BJS 2017; 104: 1837-1846.
Published: 9th August 2017
Authors: S. D. Nelen, M. van Putten, V. E. P. P. Lemmens, K. Bosscha, J. H. W. de Wilt, R. H. A. Verhoeven et al.
This study assessed trends in the treatment and survival of palliatively treated patients with gastric cancer, with a focus on age‐related differences.
For this retrospective, population‐based, nationwide cohort study, all patients diagnosed between 1989 and 2013 with non‐cardia gastric cancer with metastasized disease or invasion into adjacent structures were selected from the Netherlands Cancer Registry. Trends in treatment and 2‐year overall survival were analysed and compared between younger (age less than 70 years) and older (aged 70 years or more) patients. Analyses were done for five consecutive periods of 5 years, from 1989–1993 to 2009–2013. Multivariable logistic regression analysis was used to examine the probability of undergoing surgery. Multivariable Cox regression analysis was used to identify independent risk factors for death.
Palliative resection rates decreased significantly in both younger and older patients, from 24·5 and 26·2 per cent to 3·0 and 5·0 per cent respectively. Compared with patients who received chemotherapy alone, both younger (21·6
Despite changes in the use of resection and chemotherapy as palliative treatment, overall survival rates of patients with advanced and metastatic gastric cancer did not improve.Full text
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