Presentation and prognosis of gastric cancer in patients aged 80 years and older

The aim of this study was to analyze the characteristics of the presentation and prognosis of patients aged > 80 who were diagnosed with gastric adenocarcinoma. We have used a retrospective cohort study of 2334 patients diagnosed between 1975 and 1993 in northwestern Spain, 263 (11.3%)of whom were greater than or equal to 80 years of age. No differences were observed with respect to patients of a younger age at diagnosis regarding the site of the tumor, extension of the disease, or Lauren's histologic type. However, fewer resections with curative intent were performed in the older group (49.1% vs. 30.1%; p < 0.0001). Among those operated on with curative or palliative intent, at the end of the first month the survival probability was 0.9 and the 0.95% confidence interval (CI 95%) was 0.93-0.97 for patients < 80 years of age and 0.93 (CI 95% 0.89-0.98) for the older group (p = 0.19). At the end of 5 years of follow-up these probabilities were 0.29 (CI 95% 0.274.31) and 0.18 (CI 95% 0.14-0.23), respectively (p < 0.0001). If we consider only those patients undergoing curative resection, the survival probability for the two groups (p = 0.4) was not statistically different. In conclusion, although the two groups showed similar characteristics at presentation, patients greater than or equal to 80 years of age underwent surgery with curative intent less frequently and their general prognosis was worse. Our data support the idea that curative surgery should not be ruled out exclusively for reasons of age.