Outcome of gastric cancer in the elderly: a population-based evaluation of the Munich Cancer Registry
Background Gastric cancer accounts for 5 % of cancer deaths. Proportions of older stomach cancer patients are increasing. Despite the still poor prognosis, standardised treatment has achieved improvements; nonetheless it is questionable whether all age groups have benefitted. Age and outcome need to...
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| Veröffentlicht in: | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2016-07, Vol.19 (3), p.713-722 |
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| container_title | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association |
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| creator | Schlesinger-Raab, Anne Mihaljevic, André L. Egert, Silvia Emeny, Rebecca Jauch, Karl-Walter Kleeff, Jörg Novotny, Alexander Nüssler, Natascha C. Rottmann, Miriam Schepp, Wolfgang Schmitt, Wolfgang Schubert-Fritschle, Gabriele Weber, Bernhard Schuhmacher, Christoph Engel, Jutta |
| description | Background
Gastric cancer accounts for 5 % of cancer deaths. Proportions of older stomach cancer patients are increasing. Despite the still poor prognosis, standardised treatment has achieved improvements; nonetheless it is questionable whether all age groups have benefitted. Age and outcome need to be examined in a population-based setting.
Methods
Analyses included Munich Cancer Registry (MCR) data from 8601 invasive gastric cancer patients, diagnosed between 1998 and 2012. Tumour and therapy characteristics and outcome were analysed by two age groups ( |
| doi_str_mv | 10.1007/s10120-015-0527-7 |
| format | Article |
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Gastric cancer accounts for 5 % of cancer deaths. Proportions of older stomach cancer patients are increasing. Despite the still poor prognosis, standardised treatment has achieved improvements; nonetheless it is questionable whether all age groups have benefitted. Age and outcome need to be examined in a population-based setting.
Methods
Analyses included Munich Cancer Registry (MCR) data from 8601 invasive gastric cancer patients, diagnosed between 1998 and 2012. Tumour and therapy characteristics and outcome were analysed by two age groups (<70 vs. ≥70 years). Survival was analysed using the Kaplan-Meier method and relative survival was computed as an estimation for cancer-specific survival. Additional landmark analyses were conducted by calculating conditional survival of patients who survived more than 6 months.
Results
Fifty-nine per cent of the cohort were ≥70 years old. These patients had tumours with a slightly better prognosis and were treated with less radical surgery and adjuvant therapy than younger patients. The 5-year relative survival was 40 % for the youngest (<50 years) and 23 % for the oldest patients (≥80 years). Survival differences were diminished or eliminated after landmark analyses:
The 5-year relative survival in age groups 50–59, 60–69 and 70–79 years was comparable (between 48 and 49.6 %) and slightly worse in the youngest and oldest (45 %), which may be explained by more aggressive tumours and effects of cellular senescence, respectively.
Conclusion
The treatment and care of elderly gastric cancer patients in the MCR catchment area seems appropriate: if a patient’s general condition allows oncologic resection and chemotherapy, it is conducted and the result is comparable between age groups.</description><identifier>ISSN: 1436-3291</identifier><identifier>EISSN: 1436-3305</identifier><identifier>DOI: 10.1007/s10120-015-0527-7</identifier><identifier>PMID: 26260874</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Abdominal Surgery ; Adenocarcinoma - epidemiology ; Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - therapy ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Cancer Research ; Carcinoma, Signet Ring Cell - epidemiology ; Carcinoma, Signet Ring Cell - mortality ; Carcinoma, Signet Ring Cell - pathology ; Carcinoma, Signet Ring Cell - therapy ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Gastrectomy ; Gastric cancer ; Gastroenterology ; Germany - epidemiology ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Oncology ; Original Article ; Prognosis ; Registries ; Stomach Neoplasms - epidemiology ; Stomach Neoplasms - mortality ; Stomach Neoplasms - pathology ; Stomach Neoplasms - therapy ; Surgical Oncology ; Survival Rate ; Young Adult</subject><ispartof>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2016-07, Vol.19 (3), p.713-722</ispartof><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2015</rights><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-ff455797896c9a1a54d283510212292851d8d14b342d3366ca3b6df0f7c645943</citedby><cites>FETCH-LOGICAL-c466t-ff455797896c9a1a54d283510212292851d8d14b342d3366ca3b6df0f7c645943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10120-015-0527-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10120-015-0527-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26260874$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schlesinger-Raab, Anne</creatorcontrib><creatorcontrib>Mihaljevic, André L.</creatorcontrib><creatorcontrib>Egert, Silvia</creatorcontrib><creatorcontrib>Emeny, Rebecca</creatorcontrib><creatorcontrib>Jauch, Karl-Walter</creatorcontrib><creatorcontrib>Kleeff, Jörg</creatorcontrib><creatorcontrib>Novotny, Alexander</creatorcontrib><creatorcontrib>Nüssler, Natascha C.</creatorcontrib><creatorcontrib>Rottmann, Miriam</creatorcontrib><creatorcontrib>Schepp, Wolfgang</creatorcontrib><creatorcontrib>Schmitt, Wolfgang</creatorcontrib><creatorcontrib>Schubert-Fritschle, Gabriele</creatorcontrib><creatorcontrib>Weber, Bernhard</creatorcontrib><creatorcontrib>Schuhmacher, Christoph</creatorcontrib><creatorcontrib>Engel, Jutta</creatorcontrib><title>Outcome of gastric cancer in the elderly: a population-based evaluation of the Munich Cancer Registry</title><title>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</title><addtitle>Gastric Cancer</addtitle><addtitle>Gastric Cancer</addtitle><description>Background
Gastric cancer accounts for 5 % of cancer deaths. Proportions of older stomach cancer patients are increasing. Despite the still poor prognosis, standardised treatment has achieved improvements; nonetheless it is questionable whether all age groups have benefitted. Age and outcome need to be examined in a population-based setting.
Methods
Analyses included Munich Cancer Registry (MCR) data from 8601 invasive gastric cancer patients, diagnosed between 1998 and 2012. Tumour and therapy characteristics and outcome were analysed by two age groups (<70 vs. ≥70 years). Survival was analysed using the Kaplan-Meier method and relative survival was computed as an estimation for cancer-specific survival. Additional landmark analyses were conducted by calculating conditional survival of patients who survived more than 6 months.
Results
Fifty-nine per cent of the cohort were ≥70 years old. These patients had tumours with a slightly better prognosis and were treated with less radical surgery and adjuvant therapy than younger patients. The 5-year relative survival was 40 % for the youngest (<50 years) and 23 % for the oldest patients (≥80 years). Survival differences were diminished or eliminated after landmark analyses:
The 5-year relative survival in age groups 50–59, 60–69 and 70–79 years was comparable (between 48 and 49.6 %) and slightly worse in the youngest and oldest (45 %), which may be explained by more aggressive tumours and effects of cellular senescence, respectively.
Conclusion
The treatment and care of elderly gastric cancer patients in the MCR catchment area seems appropriate: if a patient’s general condition allows oncologic resection and chemotherapy, it is conducted and the result is comparable between age groups.</description><subject>Abdominal Surgery</subject><subject>Adenocarcinoma - epidemiology</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Cancer Research</subject><subject>Carcinoma, Signet Ring Cell - epidemiology</subject><subject>Carcinoma, Signet Ring Cell - mortality</subject><subject>Carcinoma, Signet Ring Cell - pathology</subject><subject>Carcinoma, Signet Ring Cell - therapy</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastrectomy</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Germany - epidemiology</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Prognosis</subject><subject>Registries</subject><subject>Stomach Neoplasms - epidemiology</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - therapy</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><subject>Young Adult</subject><issn>1436-3291</issn><issn>1436-3305</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kVtLwzAYhoMoOqc_wBsJeONNNV-OrXcyPIEyEL0OWZpuHV07k1bYvze1m4jgVULyvE_C9yJ0BuQKCFHXAQhQkhAQCRFUJWoPjYAzmTBGxP5uTzM4QschLEkEM5CH6IhKKkmq-Ai5adfaZuVwU-C5Ca0vLbamts7jssbtwmFX5c5Xmxts8LpZd5Vpy6ZOZia4HLtPU3XfB32-p1-6urQLPBkUr25eRufmBB0UpgrudLuO0fv93dvkMXmePjxNbp8Ty6Vsk6LgQqhMpZm0mQEjeE5TJoBQoDSjqYA8zYHPGKc5Y1Jaw2YyL0ihrOQi42yMLgfv2jcfnQutXpXBuqoytWu6oCHKqZBSpRG9-IMum87X8Xc9JYFywVWkYKCsb0LwrtBrX66M32gguu9ADx3oOFrdd6D7zPnW3M1WLv9J7IYeAToAIV7Vc-d_Pf2v9QtN1I-U</recordid><startdate>20160701</startdate><enddate>20160701</enddate><creator>Schlesinger-Raab, Anne</creator><creator>Mihaljevic, André L.</creator><creator>Egert, Silvia</creator><creator>Emeny, Rebecca</creator><creator>Jauch, Karl-Walter</creator><creator>Kleeff, Jörg</creator><creator>Novotny, Alexander</creator><creator>Nüssler, Natascha C.</creator><creator>Rottmann, Miriam</creator><creator>Schepp, Wolfgang</creator><creator>Schmitt, Wolfgang</creator><creator>Schubert-Fritschle, Gabriele</creator><creator>Weber, Bernhard</creator><creator>Schuhmacher, Christoph</creator><creator>Engel, Jutta</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20160701</creationdate><title>Outcome of gastric cancer in the elderly: a population-based evaluation of the Munich Cancer Registry</title><author>Schlesinger-Raab, Anne ; Mihaljevic, André L. ; Egert, Silvia ; Emeny, Rebecca ; Jauch, Karl-Walter ; Kleeff, Jörg ; Novotny, Alexander ; Nüssler, Natascha C. ; Rottmann, Miriam ; Schepp, Wolfgang ; Schmitt, Wolfgang ; Schubert-Fritschle, Gabriele ; Weber, Bernhard ; Schuhmacher, Christoph ; Engel, Jutta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-ff455797896c9a1a54d283510212292851d8d14b342d3366ca3b6df0f7c645943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Abdominal Surgery</topic><topic>Adenocarcinoma - epidemiology</topic><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Cancer Research</topic><topic>Carcinoma, Signet Ring Cell - epidemiology</topic><topic>Carcinoma, Signet Ring Cell - mortality</topic><topic>Carcinoma, Signet Ring Cell - pathology</topic><topic>Carcinoma, Signet Ring Cell - therapy</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastrectomy</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Germany - epidemiology</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Grading</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Prognosis</topic><topic>Registries</topic><topic>Stomach Neoplasms - epidemiology</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - therapy</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schlesinger-Raab, Anne</creatorcontrib><creatorcontrib>Mihaljevic, André L.</creatorcontrib><creatorcontrib>Egert, Silvia</creatorcontrib><creatorcontrib>Emeny, Rebecca</creatorcontrib><creatorcontrib>Jauch, Karl-Walter</creatorcontrib><creatorcontrib>Kleeff, Jörg</creatorcontrib><creatorcontrib>Novotny, Alexander</creatorcontrib><creatorcontrib>Nüssler, Natascha C.</creatorcontrib><creatorcontrib>Rottmann, Miriam</creatorcontrib><creatorcontrib>Schepp, Wolfgang</creatorcontrib><creatorcontrib>Schmitt, Wolfgang</creatorcontrib><creatorcontrib>Schubert-Fritschle, Gabriele</creatorcontrib><creatorcontrib>Weber, Bernhard</creatorcontrib><creatorcontrib>Schuhmacher, Christoph</creatorcontrib><creatorcontrib>Engel, Jutta</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schlesinger-Raab, Anne</au><au>Mihaljevic, André L.</au><au>Egert, Silvia</au><au>Emeny, Rebecca</au><au>Jauch, Karl-Walter</au><au>Kleeff, Jörg</au><au>Novotny, Alexander</au><au>Nüssler, Natascha C.</au><au>Rottmann, Miriam</au><au>Schepp, Wolfgang</au><au>Schmitt, Wolfgang</au><au>Schubert-Fritschle, Gabriele</au><au>Weber, Bernhard</au><au>Schuhmacher, Christoph</au><au>Engel, Jutta</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome of gastric cancer in the elderly: a population-based evaluation of the Munich Cancer Registry</atitle><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle><stitle>Gastric Cancer</stitle><addtitle>Gastric Cancer</addtitle><date>2016-07-01</date><risdate>2016</risdate><volume>19</volume><issue>3</issue><spage>713</spage><epage>722</epage><pages>713-722</pages><issn>1436-3291</issn><eissn>1436-3305</eissn><abstract>Background
Gastric cancer accounts for 5 % of cancer deaths. Proportions of older stomach cancer patients are increasing. Despite the still poor prognosis, standardised treatment has achieved improvements; nonetheless it is questionable whether all age groups have benefitted. Age and outcome need to be examined in a population-based setting.
Methods
Analyses included Munich Cancer Registry (MCR) data from 8601 invasive gastric cancer patients, diagnosed between 1998 and 2012. Tumour and therapy characteristics and outcome were analysed by two age groups (<70 vs. ≥70 years). Survival was analysed using the Kaplan-Meier method and relative survival was computed as an estimation for cancer-specific survival. Additional landmark analyses were conducted by calculating conditional survival of patients who survived more than 6 months.
Results
Fifty-nine per cent of the cohort were ≥70 years old. These patients had tumours with a slightly better prognosis and were treated with less radical surgery and adjuvant therapy than younger patients. The 5-year relative survival was 40 % for the youngest (<50 years) and 23 % for the oldest patients (≥80 years). Survival differences were diminished or eliminated after landmark analyses:
The 5-year relative survival in age groups 50–59, 60–69 and 70–79 years was comparable (between 48 and 49.6 %) and slightly worse in the youngest and oldest (45 %), which may be explained by more aggressive tumours and effects of cellular senescence, respectively.
Conclusion
The treatment and care of elderly gastric cancer patients in the MCR catchment area seems appropriate: if a patient’s general condition allows oncologic resection and chemotherapy, it is conducted and the result is comparable between age groups.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>26260874</pmid><doi>10.1007/s10120-015-0527-7</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1436-3291 |
| ispartof | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2016-07, Vol.19 (3), p.713-722 |
| issn | 1436-3291 1436-3305 |
| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Adenocarcinoma - epidemiology Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - therapy Adult Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use Cancer Research Carcinoma, Signet Ring Cell - epidemiology Carcinoma, Signet Ring Cell - mortality Carcinoma, Signet Ring Cell - pathology Carcinoma, Signet Ring Cell - therapy Combined Modality Therapy Female Follow-Up Studies Gastrectomy Gastric cancer Gastroenterology Germany - epidemiology Humans Male Medicine Medicine & Public Health Middle Aged Neoplasm Grading Neoplasm Staging Oncology Original Article Prognosis Registries Stomach Neoplasms - epidemiology Stomach Neoplasms - mortality Stomach Neoplasms - pathology Stomach Neoplasms - therapy Surgical Oncology Survival Rate Young Adult |
| title | Outcome of gastric cancer in the elderly: a population-based evaluation of the Munich Cancer Registry |
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