The Impact of Intervention on Survival of Elderly Patients with Gastric Cancer at IV Stage: A SEER Population-Based Study.

Abstract

Background The selection of therapeutic regimens for elderly patients with gastric cancer (GC) has attracted much attention. However, few clinical trials have been conducted concerning the subpopulation of patients diagnosed with stage IV disease. In this study, cases from the Surveillance, Epidemiologic and End Results (SEER) database were collected to investigate the effects of surgery and chemotherapy (CT) on the survival benefit in elderly GC patients with stage IV disease. Methods GC patients aged >65 years diagnosed with stage IV disease between 1973 and 2014 in the SEER database were included in the study pool based on strict inclusion and exclusion criteria. Univariate and multivariate analyses were employed to determine prognostic factors for overall survival (OS) and cancer-specific survival (CSS). Kaplan-Meier survival analysis was conducted to investigate the effects of different intervention methods on OS and CSS. Results A total of 9,306 patients were selected from the SEER database. The results showed that patients who received both surgery and chemotherapy significantly obtained OS and CSS benefits (P < 0.0001). Compared with the no surgery and CT group, the CT alone group (P < 0.0001) and the surgery alone group (P < 0.0001) had prolonged survival time. Furthermore, age and grade stratifications served as important indicators for the selection of therapeutic regimens Conclusions Surgery combined with CT outperformed monotherapy or no therapy strategies for elderly patients with stage IV disease.