Guideline recommended gastric cancer care in the elderly: insights into the applicability of cancer trials to real world.

Annals of Surgical Oncology
Vikas DudejaWaddah B Al-Refaie

Abstract

Given the underrepresentation of older persons in cancer trials, the association between increasing age and receipt of recommended gastric cancer care in the United States was examined. Using the 1998-2006 SEER database, 8637 Medicare-eligible patients, aged ≥ 65 years who underwent gastrectomy for nonmetastatic gastric adenocarcinoma were identified. Multivariate analyses was used to assess the effect of increasing age on receipt of recommended gastric cancer care (adequate lymph node evaluation [≥ 15 lymph nodes] and adjuvant radiation therapy for AJCC Ib-IVM0) and cancer-specific mortality controlling for covariates. While 61% of gastric cancer operations were performed in patients ≥ 65 years, less than 30% received adequate lymphadenectomy or adjuvant radiation therapy. Older patients were less likely to receive adequate nodal evaluation and adjuvant radiotherapy (P < 0.0001). These findings persisted on multivariate analyses. Older age was also associated with worse cancer-specific mortality. Because an age-tumor location interaction for cancer mortality (P = 0.047) was observed, stratified analyses were performed which showed that the adverse effect of older age on cancer-specific mortality was augmented in proximal gastr...Continue Reading

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Citations

Apr 8, 2014·World Journal of Gastroenterology : WJG·Xu-Guang JiaoHan Liang
Jan 25, 2012·TheScientificWorldJournal·Gopal C KowdleySteven C Cunningham
Aug 13, 2011·Annals of Surgical Oncology·Vikas DudejaWaddah B Al-Refaie
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Sep 7, 2014·Annals of Surgical Oncology·Gary B DeutschAnton J Bilchik
Jun 13, 2018·Journal of Cancer Research and Therapeutics·Mustafa KaracaAhmet Özet
Mar 30, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Peng-Liang WangHui-Mian Xu
Nov 18, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Vikas DudejaWaddah B Al-Refaie
Feb 22, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jun-Te HsuTa-Sen Yeh
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Oct 28, 2020·Clinical and Translational Gastroenterology·Yuming JiangGuoxin Li
May 22, 2021·Journal of Gastrointestinal Cancer·Irénée NiyongombwaEgide Abahuje

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