Comparison of Outcomes for Elderly Gastric Cancer Patients at Least 80 Years of Age Following Gastrectomy in the United States and China
The aim of this study was to compare gastric cancer (GC) patients aged 80 years or older undergoing gastrectomy at two high-volume cancer centers in the US and China.
Patients aged ≥ 80 years who underwent R0 resection at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, USA (n = 159), and Fujian Medical University Union Hospital (FMUUH) in Fujian, China (n = 118) from January 2000 to December 2013 were included. Demographic, surgical, and pathologic variables were compared, and factors associated with survival were determined via multivariate analysis.
The number of patients increased annually in the FMUUH cohort but not in the MSKCC cohort. Patients at MSKCC were slightly older (mean age 83.7 vs. 82.7 years), more commonly female (38 vs. 19%), and had higher average body mass index (BMI; 26 vs. 23). Treatment at FMUUH more frequently employed total gastrectomy (59 vs. 20%) and laparoscopic surgery (65 vs. 7%), and less frequently included adjuvant therapy (11 vs. 18%). In addition, FMUUH patients had larger tumors of more advanced T, N, and TNM stage. Morbidity (35 vs. 25%, p = 0.08) and 30-day mortality (2.5 vs. 3.3%, p = 0.67) were similar between the cohorts. For each TNM stage, there was no significant difference between MSKCC and FMUUH patients in 5-year overall survival and disease-specific survival (DSS). TNM stage was the only independent predictor of DSS for both cohorts.
Patients ≥ 80 years of age selected for gastrectomy for GC at MSKCC and FMUUH had acceptable morbidity and mortality, and DSS was primarily dependent on TNM stage.
The authors thank Jessica Moore, Senior Editor, Department of Surgery, MSKCC, for editing.
This research was funded in part by NIH/NCI Cancer Center Support Grant P30 CA008748, the Scientific and Technological Innovation Joint Capital Projects of Fujian Province, China (No. 2016Y9031), and the Construction Project of Fujian Province Minimally Invasive Medical Center [No. (2017) 171].
Jian-Xian Lin, Brendan C. Yi, Changhwan Yoon, Ping Li, Chao-Hui Zheng, Chang-Ming Huang, and Sam S. Yoon have no commercial interests related to this research.
This research was approved by the Ethics Committees of MSKCC and FMUUH. All procedures were in accordance with institutional and national ethical standards on human experimentation and with the Helsinki Declaration. Informed consent was obtained from all patients.
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