OBJECTIVETo investigate the clinical manifestations,treatment,and prognosis of gastric cancer in the elderly patients.

METHODA total of 252 patients with gastric cancer who admitted to the Oncology Department of Peking Union Medical College Hospital were divided into elderly group (≥ 65 years) and non-elderly group (< 65 years) and the clinical characteristics of these two groups were analyzed and compared.

RESULTSThe elderly accounted for 36.0% of all gastric cancer patients in our department. The proportion of male was significantly higher in elderly group than non-elderly group (male:female = 3.74:1, P=0.020). Abdominal satiety and pain were the most common symptoms,which were significantly lower in elderly group (43.3% vs. 61.7%, P=0.005). However,the frequency of weight loss was significantly higher in the elderly group (15.6% vs. 6.2%, P = 0.015). Significantly more elderly patients with gastric cancer were found the second tumors (12.2% vs. 2.5%, P=0.002). The most common tumor location was cardia (36.7%) in elderly group and antrum (34.6%) in non-elderly group. A small proportion (2.2%) of elderly patients had multi-original lesions, which was not found in non-elderly group. The overall rate of surgery and R0 resection rate were 77.8% and 70.9% respectively, which were similar in both groups. The overall rate of chemotherapy was 98%. The ratio was one third compared with younger patients who received three and more than three lines chemotherapy (3.3% vs. 9.3%), but did not reach statistical difference. More elderly patients chose FOLFOX / XELOX regimen (73.3%) compared with younger arm. The median survival time was 26.5 months in elderly group and 28.0 months in non-elderly group (P=0.835). Subgroup analysis showed that the median survival time of stage 4 gastric cancer was longer in elderly group than in non-elderly group (22.7 months and 16.1 months, respectively; P=0.057), which was marginally statistically significant.

CONCLUSIONSMore old men may get gastric cancer. More elderly patients may present with weight loss. Cardia is the most common tumor location. The ratio of multi-original lesions and secondary tumors is higher for elderly patients. Elderly patients with good performance status can receive surgery and chemotherapy safely. The resection rate is similar between elderly and non-elderly patients. Elderly patients receive more two-drug combination regimens. The overall prognoses are similar between elderly patients and non-elderly patients.