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Cancer

Postoperative Adjuvant Chemotherapy in Older Adults with Gastric Cancer: A Population-Based Study

Strategic Insights

— 2 min read

Research by a team of investigators from Beijing Hospital has shed light on the effectiveness of postoperative adjuvant chemotherapy in adults aged 80 years with locally advanced gastric cancer (LAGC). The study, published in the journal Discover Oncology, aimed to assess the benefits of adjuvant chemotherapy in this age group using data from the Surveillance, Epidemiology, and End Results (SEER) database. The findings suggest that postoperative adjuvant chemotherapy offers significant survival benefits for patients aged 80 years with LAGC, particularly those with lymph node involvement.

Key Takeaways:

  • A total of 2395 patients with LAGC aged 80 years who underwent radical surgery between 2004 and 2015 were identified.
  • Propensity score matching (1:1) was applied to pair 422 patients receiving adjuvant chemotherapy with 1973 patients who underwent surgery alone.
  • Multivariate logistic regression identified independent predictors of adjuvant chemotherapy, including the period from 2012-2015, pN1-2 and pN3 stages, and radiation therapy.
  • Conversely, age 85 years predicted decreased chemotherapy use.
  • Cancer-specific survival (CSS) and overall survival (OS) were compared using multivariate Cox analysis, showing significantly longer OS and CSS in the adjuvant chemotherapy group, before and after matching.
  • Subgroup analysis revealed that patients aged 80-84 years and those with N + stages benefited most from adjuvant chemotherapy, whereas patients aged 90 years did not show significant benefit.
  • The study concluded that postoperative adjuvant chemotherapy should be considered for patients aged 80 years with LAGC, especially those with lymph node involvement, as it offers significant survival benefits.
  • However, as age approaches 90 years, the benefits of adjuvant chemotherapy may diminish, warranting more cautious application.

Statistics:

  • The study included 2395 patients with LAGC aged 80 years who underwent radical surgery between 2004 and 2015.
  • 422 patients received adjuvant chemotherapy, while 1973 patients underwent surgery alone.
  • The period from 2012-2015 was associated with an increased use of adjuvant chemotherapy.
  • Patients with pN1-2 and pN3 stages were more likely to receive adjuvant chemotherapy.
  • Radiation therapy was also found to be an independent predictor of adjuvant chemotherapy use.
  • Patients aged 80-84 years and those with N + stages showed the most significant benefits from adjuvant chemotherapy.

Sources:

  • Survival benefits of postoperative adjuvant chemotherapy in adults aged 80 years with locally advanced gastric cancer: insights from a population-based study. Discover Oncology, 2025,16(1):1-13.
  • National High-level Hospital Clinical Research Funding.
  • Fuhai Ma, Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences.
  • Yangyang Zheng, Jian Cui, Zijian Li, Jinxin Shi, Tianming Ma, Xianglong Cao, Tao Yu, Guoju Wu, Gang Zhao, Jinghai Song, Qi An.

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