Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Clinical and Translational Oncology
Erschienen in: Clinical and Translational Oncology 5/2013

01.05.2013 | Research Article

Advanced or metastatic gastric cancer in elderly patients: clinicopathological, prognostic factors and treatments

verfasst von: Z. Lu, M. Lu, X. Zhang, J. Li, J. Zhou, J. Gong, J. Gao, J. Li, X. Zhang, Y. Li, L. Shen

Erschienen in: Clinical and Translational Oncology | Ausgabe 5/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To analyze the clinicopathological features, prognostic factors, treatment efficacy and safety among elderly patients with advanced or metastatic gastric cancer.

Methods

Three hundred and nineteen patients aged 65 years and older, diagnosed with advanced or metastatic gastric cancer, were followed and data were retrospectively collected, reviewed and analyzed.

Results

The elderly patients carried specific clinicopathological characteristics. Body mass index (BMI), number of metastatic lesions, ascites, Karnofsky performance score (KPS), tumor differentiation grade, lactate dehydrogenase (LDH) level, local treatment, and chemotherapy were the independent prognostic factors. Serum LDH level was superior to the serum CEA level in the prognosis of advanced or metastatic gastric cancer in older patients. Cisplatin-based regimen, chemotherapy cycles, metastatic lesions, LDH level, and supraclavicular lymph node metastasis were the independent prognostic factors in 220 patients receiving chemotherapy. The toxicity was mild and tolerable.

Conclusion

KPS, BMI and a well-differentiated histopathology were factors favoring longer survival, whereas elevated serum LDH and a greater number of metastatic lesions were associated with poor prognosis among those elderly patients. Cisplatin-based chemotherapy provided survival benefits and mild toxicity.
Literatur
1.
Munoz N, Franceschi S (1997) Epidemiology of gastric cancer and perspectives for prevention. Salud Publica Mex 39:318–330PubMed
2.
Kamangar F, Dores GM, Anderson WF (2006) Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 24:2137–2150PubMedCrossRef
3.
Bruckner HW, Morris JC, Mansfield P (2000) Neoplasms of the stomach. In: Cancer medicine, 5th edn. BC Decker, Hamilton, pp 1355–1390
4.
Wu CX, Zheng Y, Bao PP et al (2008) Pattern of changing incidence of gastric cancer and its time trend in Shanghai. J Surg Concerpts Pract 13:24–29
5.
Arai T, Takubo K (2007) Clinicopathological and molecular characteristics of gastric and colorectal carcinomas in the elderly. Pathol Int 57:303–314PubMedCrossRef
6.
Cascinu S, Labianca R, Alessandroni P et al (1997) Intensive weekly chemotherapy for advanced gastric cancer using fluorouracil, cisplatin, epi-doxorubicin, 6S-leucovorin, glutathione, and filgrastim: a report from the Italian Group for the Study of Digestive Tract Cancer. J Clin Oncol 15:3313–3319PubMed
7.
Cascinu S, Scartozzi M, Labianca R et al (2004) High curative resection rate with weekly cisplatin, 5-fluorouracil, epidoxorubicin, 6S-leucovorin, glutathione, and filgastrim in patients with locally advanced, unresectable gastric cancer: a report from the Italian Group for the Study of Digestive Tract Cancer [GISCAD]. Br J Cancer 8:1521–1525CrossRef
8.
Habu H, Endo M (1989) Gastric cancer in elderly patients: results of surgical treatment. Hepatogastroenterology 36:71–74PubMed
9.
Fujimoto S, Takahashi M, Ohkubo H et al (1994) Comparative clinicopathologic features of early gastric cancer in young and older patients. Surgery 115:516–520PubMed
10.
Wang JY, Hsieh JS, Huang CJ et al (1996) Clinicopathologic study of advanced gastric cancer without serosal invasion in young and old patients. J Surg Oncol 63:36–40PubMedCrossRef
11.
Saif MW, Makrilia N, Zalonis A et al (2010) Gastric cancer in the elderly: an overview. Eur J Surg Oncol 36:709–717PubMedCrossRef
12.
Arai T, Esaki Y, Inoshita N et al (2004) Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients. Gastric Cancer 7:154–159PubMedCrossRef
13.
Ishigami S, Natsugoe S, Saihara T et al (1997) Clinical and pathologic features of early gastric cancer in elderly patients. Hepatogastroenterology 44:1164–1168PubMed
14.
Inoshita N, Yanagisawa A, Arai T et al (1998) Pathological characteristics of gastric carcinomas in the very old. Jpn J Cancer Res 89:1087–1092PubMedCrossRef
15.
Wu CW, Lo SS, Shen KH et al (2000) Surgical mortality, survival and quality of life after resection for gastric cancer in the elderly. World J Surg 24:465–472PubMedCrossRef
16.
Maehara Y, Emi Y, Tomisaki S et al (1996) Age-related characteristics of gastric carcinoma in young and elderly patients. Cancer 77:1774–1780PubMedCrossRef
17.
Nielsen J, Aagaard J, Toftgaard C (1985) Gastric cancer with special reference to prognostic factors: a review of 779 cases. Acta Chir Scand 151:49–55PubMed
18.
Chau I, Norman AR, Cunningham D et al (2004) Multivariate prognostic factor analysis in locally advanced and metastatic esophago-gastric cancer-pooled analysis from three multicenter, randomised, controlled trials using individual patient data. J Clin Oncol 22:2395–2403PubMedCrossRef
19.
Sudo H, Takagi Y, Katayanagi S et al (2006) Bone metastasis of gastric cancer. Gan To Kagaku Ryoho 33:1058–1060PubMed
20.
Glimelius B, Ekström K, Hoffman K et al (1997) Randomised comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 8:163–168PubMedCrossRef
21.
Pyrhönen S, Kuitunen T, Nyandoto P et al (1995) Randomised comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with non-resectable gastric cancer. Br J Cancer 71:587–591PubMedCrossRef
22.
Murad AM, Santiago FF, Petroianu A et al (1993) Modified therapy with 5-fluorouracil, doxorubicin, and methotrexate in advanced gastric cancer. Cancer 72:37–41PubMedCrossRef
23.
Trumper M, Ross PJ, Cunningham D et al (2006) Efficacy and tolerability of chemotherapy in elderly patients with advanced oesophago-gastric cancer: a pooled analysis of three clinical trials. Eur J Cancer 42:827–834PubMedCrossRef
24.
Santini D, Graziano F, Catalano V et al (2006) Weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF) as first-line chemotherapy for elderly patients with advanced gastric cancer: results of a phase II trial. BMC Cancer 6:125PubMedCrossRef
25.
Graziano F, Santini D, Testa E et al (2003) A phase II study of weekly cisplatin, 6S-stereoisomer leucovorin and fluorouracil as first-line chemotherapy for elderly patients with advanced gastric cancer. Br J Cancer 89:1428–1432PubMedCrossRef
26.
Koizumi W, Narahara H, Hara T et al (2008) S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 9:215–221PubMedCrossRef
27.
Seol YM, Song MK, Choi YJ et al (2009) Oral fluoropyrimidines (capecitabine or S-1) and cisplatin as first line treatment in elderly patients with advanced gastric cancer: a retrospective study. Jpn J Clin Oncol 39:43–48PubMedCrossRef
28.
Tsushima T, Hironaka S, Boku N et al (2010) Safety and efficacy of S-1 monotherapy in elderly patients with advanced gastric cancer. Gastric Cancer 13:245–250PubMedCrossRef
29.
Lee JL, Kang YK, Kang HJ et al (2008) A randomised multicentre phase II trial of capecitabine vs S-1 as first-line treatment in elderly patients with metastatic or recurrent unresectable gastric cancer. Br J Cancer 99:584–590PubMedCrossRef
30.
Tsuji A, Shima Y, Morita S et al (2008) Combination chemotherapy of S-1 and low-dose twice-weekly cisplatin for advanced and recurrent gastric cancer in an outpatient setting: a retrospective study. Anticancer Res 28:1433–1438PubMed
Metadaten
Titel
Advanced or metastatic gastric cancer in elderly patients: clinicopathological, prognostic factors and treatments
verfasst von
Z. Lu
M. Lu
X. Zhang
J. Li
J. Zhou
J. Gong
J. Gao
J. Li
X. Zhang
Y. Li
L. Shen
Publikationsdatum
01.05.2013
Verlag
Springer Milan
Erschienen in
Clinical and Translational Oncology / Ausgabe 5/2013
Print ISSN: 1699-048X
Elektronische ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-012-0938-4

Weitere Artikel der Ausgabe 5/2013

Clinical and Translational Oncology 5/2013 Zur Ausgabe

Research Article

Clinical and mutation analysis of four Chinese families with von Hippel-Lindau disease

Research Article

Prognostic significance of NSE mRNA in advanced NSCLC treated with gefitinib

Erratum

Erratum to: Polymorphisms in HIF-1alpha affect presence of lymph node metastasis and can influence tumor size in squamous-cell carcinoma of the glottic larynx

Research Article

Modified DCF (mDCF) regimen seems to be as effective as original DCF in advanced gastric cancer (AGC)

Research Article

Dose–volume histogram parameters for predicting radiation pneumonitis using receiver operating characteristic curve

Educational Series – Red Series

An update on molecularly targeted therapies in second- and third-line treatment in non-small cell lung cancer: focus on EGFR inhibitors and anti-angiogenic agents

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

25.04.2024 NSCLC Nachrichten

Das Risiko für Rezidiv oder Tod von Patienten und Patientinnen mit reseziertem ALK-positivem NSCLC ist unter einer adjuvanten Therapie mit dem Tyrosinkinase-Inhibitor Alectinib signifikant geringer als unter platinbasierter Chemotherapie.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

23.04.2024 Medikamente in Schwangerschaft und Stillzeit Nachrichten

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise