Impact of age on stage-specific mortality in patients with gastric cancer: A long-term prospective cohort study

by Jae Gon Lee, Shin Ah Kim, Chang Soo Eun, Dong Soo Han, Yong Sung Kim, Bo Youl Choi, Kyu Sang Song, Hyun Ja Kim, Chan Hyuk Park

Controversies exist regarding the impact of age on gastric cancer-related mortality according to cancer stage. In our prospective cohort study, we evaluated the impact of age on stage-specific mortality in patients with gastric cancer. Between 2002 and 2006, patients with newly diagnosed gastric cancer were recruited from two university-affiliated hospitals in Korea. Follow-up data were updated regularly based on medical records and telephone surveys. Patients were classified into four subgroups according to age: <50, 50–59, 60–69, and 70–79 years. A total of 448 patients were followed up for 81.6 months (interquartile range, 25.0–139.3 months). The number of patients with stage I, II, III, and IV disease was 247, 74, 88, and 39, respectively. Overall, age was an independent risk factor for gastric cancer-specific mortality (hazard ratio [HR], [95% confidence interval (CI)]: 1.53 [0.91–2.57], 1.88 [1.21–2.91], and 2.64 [1.69–4.14] in the 50–59, 60–69, and 70–79 years groups, respectively, with the <50 years group as reference). In patients with stage I and II gastric cancer, the 70–79 years group was associated with a significantly higher rate of cancer-specific mortality than the <50 years group (stage I: HR [95% CI], 9.55 [2.11–43.12]; stage II: HR [95% CI], 7.17 [2.32–22.18]). However, age was not an independently associated factor for cancer-specific mortality in patients with stage III and IV gastric cancer. Although age was an independent risk factor for gastric cancer-related mortality in patients with gastric cancer, its impact may differ depending on the stage of cancer.