Gastric cancer in the elderly: An overview

Saif, Muhammad Wasif; Makrilia, Nektaria; Zalonis, Antonis; Merikas, Manolis; Syrigos, K.

doi:10.1016/j.ejso.2010.05.023

Cited by 138 publications

(94 citation statements)

References 58 publications

(139 reference statements)

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“…In contrast to physicians' perceptions, older patients do not recognize their age as an important issue for refusing trials [24]. Furthermore, performance status is not helpful to estimate the general condition of elderly patients, and other factors regarding their functional, social, and mental status should be considered [25].…”

Section: Discussionmentioning

confidence: 99%

A phase II study of modified FOLFOX as first-line chemotherapy for metastatic gastric cancer in elderly patients with associated diseases

Catalano

Bisonni²,

Graziano

et al. 2012

Gastric Cancer

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Background Elderly patients are generally underrepresented in the study populations of combination chemotherapy trials. This study evaluates the efficacy and safety of a modified FOLFOX regimen in elderly patients with metastatic gastric cancer and presenting associated disease(s). , every 2 weeks. Assessment of response was performed every four cycles according to RECIST criteria. Results Median patient age was 74 years (range, 70-83 years). Overall response rate was 34.9 % [95 % confidence interval (CI), 20.6-49.1, with 3 complete responses and 12 partial responses. Grade 3 neutropenia occurred in 4 patients (9.3 %), fatigue in 3 patients (7.0 %), and vomiting in 2 patients (4.6 %). Grade 2 and 3 peripheral neuropathy was observed in 5 patients (11.6 %) and 1 patient (2.3 %), respectively. No treatment-related death was observed. Median progression-free and overall survival were 6.8 and 10.5 months, respectively. Conclusions This modified FOLFOX regimen is an active and well-tolerated treatment for elderly patients with metastatic gastric cancer and also represents a good therapeutic option in patients with associated disease(s).

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Section: Discussionmentioning

confidence: 99%

A phase II study of modified FOLFOX as first-line chemotherapy for metastatic gastric cancer in elderly patients with associated diseases

Catalano

Bisonni²,

Graziano

et al. 2012

Gastric Cancer

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“…Elderly patients do not usually tolerate surgery as well and often suffer from multiple postoperative complications, hence the poor prognosis (3). Therefore, gastrectomy may be a challenging surgical procedure for elderly patients with GC.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic radical gastrectomy versus traditional open surgery in elderly patients with gastric cancer: Benefits and complications

Han

et al. 2014

Molecular and Clinical Oncology

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Abstract. This study was conducted to compare the therapeutic effect and complications of laparoscopic radical gastrectomy (LRG) Compared to traditional open surgery, LRG exhibited several advantages, such as being less invasive, with less intraoperative blood loss, shorter bedbound time, less intubation time, low frequency of fever, less time to normal diet, shorter hospital stay and a low overall incidence of complications. No significant difference was observed between laparoscopic and open surgery in terms of operative time and number of lymph nodes dissected. The 3-year cancer recurrence and mortality rates were similar in the two groups. In conclusion, LRG is a safe and effective procedure for the management of GC in elderly patients and was found to be superior to traditional open surgery regarding the short-term curative effect. Therefore, LRG represents a feasible and safe surgical approach for elderly patients with GC.

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“…In literature, controversy remains about the influence of chronologic age on the nodal status in gastric carcinoma. Most previous reports have negated a significant difference in the rates of LN metastasis between younger and elderly patients [37][38][39][40], whereas in cases of early gastric cancer several authors have reported a higher prevalence of LN involvement for elderly patients [41,42].…”

Section: Survival Analysismentioning

confidence: 96%

Gastric carcinoma: stage migration by immunohistochemically detected lymph node micrometastases

Jeuck

Wittekind

2014

Gastric Cancer

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Background Immunohistochemically detected micrometastases of the regional lymph nodes in previously pN0-classified gastric cancer have been incorporated in the TNM staging system. This study aims to determine the incidence of such micrometastases in gastric carcinoma and to investigate their impact on stage grouping and prognosis. Methods Ninety-five patients with gastric carcinoma classified as pN0 by conventional histological examination were enrolled. All patients underwent gastric resection with regional lymphadenectomy between 2006 and 2010. A total of 2018 lymph nodes was obtained (median, 20 Lymph nodes) and immunohistostained with anti-pan cytokeratin antibody (KL1). Results Micrometastases were detected in regional lymph nodes by immunohistostaining in 16 out of all 95 patients. Fourteen patients were upstaged by micrometastasis-positive regional lymph nodes. Three patients demonstrated lymph nodes with isolated tumor cells alone. A significantly higher incidence of micrometastases was observed in patients with diffuse histologic type (p = 0.007) and total gastrectomy (p = 0.007). When isolated tumor cells were also regarded as lymph node involvement, the recurrence rate was significantly higher for node-positive than for node-negative patients and for those younger than 70 years (33.3 and 6.7 %, respectively; p = 0.026; n = 39). Overall survival analysis revealed no significant difference between micrometastasis-positive and micrometastasis-negative patients. ConclusionImmunohistostaining of regional lymph nodes in node-negative gastric carcinoma patients leads to an increased detection of micrometastases with significant implications for the staging system. Although no impact on survival time was shown, the higher recurrence rate for node-positive patients younger than 70 years indicates a prognostic value of immunohistochemically detectable micrometastases.

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Gastric cancer in the elderly: An overview

Cited by 138 publications

References 58 publications

A phase II study of modified FOLFOX as first-line chemotherapy for metastatic gastric cancer in elderly patients with associated diseases

A phase II study of modified FOLFOX as first-line chemotherapy for metastatic gastric cancer in elderly patients with associated diseases

Laparoscopic radical gastrectomy versus traditional open surgery in elderly patients with gastric cancer: Benefits and complications

Gastric carcinoma: stage migration by immunohistochemically detected lymph node micrometastases

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