Analysis of prognostic factors for elderly advanced gastric cancer

QU Yanli; ZHOU Ning; TANG Yong

Abstract：Objective To investigate the prognosis and related influencing factors for elderly advanced gastric cancer. Methods The data of 174 patients over 70 years with advanced gastric cancer who received chemotherapy from January 2010 and December 2012 was reviewed. Kaplan-Meier method was employed to analyze survival and Cox proportional hazard model was used for multifactor analysis.Results The response rate (RR) was 31?? 5%(51/162)and the disease control rate (DCR) was 73?? 5%(119/162).The median overallsurvival (OS) was 11?? 4 months (95% CI: 10?? 4-12?? 4) and the 1-, 2-year survival rates were 39?? 0% and 17?? 0%. The RR and medianOS of 2-drug therapy were better than those of monotherapy (35?? 8% vs. 17?? 9%, P=0?? 037; 14?? 1months vs. 7?? 5 months,P=0?? 010), butthe difference of DCR had no significance (P>0?? 05). The median OS of patients receiving chemotherapy of 1-2, 3-4 and >5 cycles were7?? 7, 13?? 1 and 21?? 5months (P<0?? 001). The median OS of receiving first-line therapy alone was shorter than those receiving second-lineafter disease progression (10?? 7 months vs. 16?? 7 months, P=0?? 006). Cox regression model showed that ECOG score, number of metastat-ic lesions, CEA, CA19-9, lactate dehydrogenase, chemotherapy cycles and the second-line chemotherapy were the independentprognostic factors influencing prognosis. Conclusion Multiple cycles of chemotherapy and the application of second-line chemotherapyafter disease progression may improve the prognosis of elderly patients bearing advanced gastric cancer.