Risk Factors for Cancer-specific Survival in Elderly Gastric Cancer Patients After Curative Gastrectomy

Overview

Journal Nutr Res Pract

Specialty Nutritional Sciences

Date 2022 Oct 14

PMID 36238382

Authors

Xiao Liu

Zhigang Xue

Jianchun Yu

Zhiqiang Ma

Weiming Kang

Xin Ye

Zijian Li

Affiliations

Soon will be listed here.

Abstract

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/m. Multivariate analysis indicated that a BMI ≤ 20.6 kg/m (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/m), 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.

Citing Articles

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Matysiak K, Hojdis A, Szewczuk M Nutrients. 2024; 16(23).

PMID: 39683445 PMC: 11643072. DOI: 10.3390/nu16234052.

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