Risk factors for cancer-specific survival in elderly gastric cancer patients after curative gastrectomy

Xiao Liu; Zhigang Xue; Jianchun Yu; Zhiqiang Ma; Weiming Kang; Xin Ye; Zijian Li

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자료유형: 학술저널

저자정보: Xiao Liu (Chinese Academy of Medical Sciences and Peking Union Medical College) Zhigang Xue (Chinese Academy of Medical Sciences and Peking Union Medical College) Jianchun Yu (Chinese Academy of Medical Sciences and Peking Union Medical College) Zhiqiang Ma (Chinese Academy of Medical Sciences and Peking Union Medical College) Weiming Kang (Chinese Academy of Medical Sciences and Peking Union Medical College) Xin Ye (Chinese Academy of Medical Sciences and Peking Union Medical College) Zijian Li (Chinese Academy of Medical Sciences and Peking Union Medical College)

저널정보: 대한지역사회영양학회 Nutrition Research and Practice Nutrition Research and Practice Vol.16 No.5

발행연도: 2022.10

수록면: 604 - 615 (12page)

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BACKGROUND/OBJECTIVES: This study aimed to investigate cancer-specific survival (CSS) and associated risk factors in elderly gastric cancer (EGC) patients.
SUBJECTS/METHODS: EGC patients (≥ 70 yrs) who underwent curative gastrectomy between January 2013 and December 2017 at our hospital were included. Clinicopathologic characteristics and survival data were collected. Receiver operating characteristic (ROC) analysis was used to extract the best cutoff point for body mass index (BMI). A Cox proportional hazards model was used to determine the risk factors for CSS.
RESULTS: In total, 290 EGC patients were included, with a median age of 74.7 yrs. The median follow-up time was 31 (1–77) mon. The postoperative 1-yr, 3-yr and 5-yr CSS rates were 93.7%, 75.9% and 65.1%, respectively. Univariate analysis revealed risk factors for CSS, including age (hazard ratio [HR] = 1.08; 95% confidence interval [CI], 1.01–1.15), intensive care unit (ICU) admission (HR = 1.73; 95% CI, 1.08–2.79), nutritional risk screening (NRS 2002) score ≥ 5 (HR = 2.33; 95% CI, 1.49–3.75), and preoperative prognostic nutrition index score < 45 (HR = 2.06; 95% CI, 1.27–3.33). The ROC curve showed that the best BMI cutoff value was 20.6 kg/m². Multivariate analysis indicated that a BMI ≤ 20.6 kg/m² (HR = 2.30; 95% CI, 1.36–3.87), ICU admission (HR = 1.97; 95% CI, 1.17–3.30) and TNM stage (stage II: HR = 5.56; 95% CI, 1.59–19.43; stage III: HR = 16.20; 95% CI, 4.99–52.59) were significantly associated with CSS.
CONCLUSIONS: Low BMI (≤ 20.6 kg/m²), ICU admission and advanced pathological TNM stages (II and III) are independent risk factors for CSS in EGC patients after curative gastrectomy. Nutrition support, better perioperative management and early diagnosis would be helpful for better survival.

#Stomach neoplasms #aged #risk factors #survival #body mass index

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