ArticleBMC cancer2019
Optimal treatment for elderly patients with resectable proximal gastric carcinoma: a real world study based on National Cancer Database.
Article in BMC cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed, 8 citations in OpenAlex.
- Feasibility and safety of enhanced recovery after surgery in elderly patients with gastric cancer.World journal of gastroenterology · 2025Article
- Review
- A Practical Nomogram for Predicting the Prognosis of Elderly Patients with Gastric Adenocarcinoma After Gastrectomy.International journal of general medicine · 2022Article
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh perioperative morbidity, mortality, and uncertain outcome of surgery in octogenarians with proximal gastric carcinoma (PGC) pose a dilemma for both patients and physicians. We aim to evaluate the risks and survival benefits of different strategies treated in this group.
methodsOctogenarians (≥80 years) with resectable proximal gastric carcinoma who were recommended for surgery were identified from National Cancer Database during 2004-2013.
resultsPatients age ≥ 80 years with PGC were less likely to be recommended or eventually undergo surgery compared to younger patients. Patients with surgery had a significantly better survival than those without surgery (5-year OS: 26% vs. 7%, p < 0.001), especially in early stage patients. However, additional chemotherapy (HR: 0.94, 95% CI: 0.82-1.08, P = 0.36) or radiotherapy (HR: 0.97, 95% CI: 0.84-1.13, P = 0.72) had limited benefits. On multivariate analysis, surgery (HR: 0.66, 95% CI: 0.51-0.86, P = 0.002) was a significant independent prognostic factor, while extensive surgery had no survival benefit (Combined organ resection: HR: 1.88, 95% CI: 1.22-2.91, P = 0.004; number of lymph nodes examined: HR: 0.99, 95% CI: 0.97-1.00, P = 0.10). Surgery performed at academic and research (AR) medical center had the best survival outcome (5-year OS: 30% in AR vs. 18-27% in other programs, P < 0.001) and lowest risk (30-day mortality: 1.5% in AR vs. 3.6-6.6% in other programs, P < 0.001; 90-day mortality: 6.2% in AR vs. 13.6-16.4% in other programs, P < 0.001) compared to other facilities.
conclusionsLess-invasive approach performed at academic and research medical center might be the optimal treatment for elderly patients aged ≥80 yrs. with early stage resectable PGC.
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