Age-specific effects on the prognosis after surgery for gastric cancer: A SEER population-based analysis

// Peng Song 1,* , Lei Wu 2,* , Bo Jiang 1,* , Zhijian Liu 1 , Ke Cao 3 and Wenxian Guan 1 1 Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China 2 Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China 3 Department of Critical Care Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China * These authors have contributed equally to this work Correspondence to: Wenxian Guan, email: // Keywords : age; prognosis; gastric cancer; SEER Received : November 16, 2015 Accepted : April 29, 2016 Published : May 21, 2016 Abstract Prognosis of age at diagnosis for gastric cancer (GC) has been investigated in a few studies with inconclusive results. To assess the survival of GC across different age groups, we searched the Surveillance, Epidemiology, and End Results (SEER) database (1988-2010) and identified 10,092 patients undergoing gastrectomy. Analyses of the associations between age and 5-year GC-specific survival (GCSS) were carried out using the Kaplan-Meier method and Cox regression model. When the 50-59 year age group was used as reference group, patients younger than 50 years suffered similar survival rates, and the risk of death increased for patients older than 60 years (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.02-1.20), peaking for ages > 80 years (HR, 1.60; 95% CI, 1.46-1.76). Overall, HRs of 5-year GCSS increased steadily with age, even when age was evaluated as a continuous variable. We assessed the survival differences associated with age between three groups, using the cut-off ages of 30 and 50 years. Compared with the elderly group, a high survival rate was observed in the mid-age group, but not in the youngest group. Stratified analysis for sex, race, tumor site, histology and clinical stage yielded consistent results. This study shows that the prognosis of GC varies with age, and young GC patients appear to have a favorable GCSS after surgical treatment. Further studies are warranted to verify our findings.