Advanced

North European comparison of treatment strategy and survival in older patients with resectable gastric cancer : A EURECCA upper gastrointestinal group analysis

Claassen, Y. H.M.; Dikken, J. L.; Hartgrink, H. H.; de Steur, W. O.; Slingerland, M.; Verhoeven, R. H.A.; van Eycken, E.; de Schutter, H.; Johansson, J. LU and Rouvelas, I., et al. (2018) In European Journal of Surgical Oncology 44(12). p.1982-1989
Abstract

Background: As older gastric cancer patients are often excluded from randomized clinical trials, the most appropriate treatment strategy for these patients remains unclear. The current study aimed to gain more insight in treatment strategies and relative survival of older patients with resectable gastric cancer across Europe. Methods: Population-based cohorts from Belgium, Denmark, The Netherlands, Norway, and Sweden were combined. Patients ≥70 years with resectable gastric cancer (cT1-4a, cN0-2, cM0), diagnosed between 2004 and 2014 were included. Resection rates, administration of chemotherapy (irrespective of surgery), and relative survival within a country according to stage were determined. Results: Overall, 6698 patients were... (More)

Background: As older gastric cancer patients are often excluded from randomized clinical trials, the most appropriate treatment strategy for these patients remains unclear. The current study aimed to gain more insight in treatment strategies and relative survival of older patients with resectable gastric cancer across Europe. Methods: Population-based cohorts from Belgium, Denmark, The Netherlands, Norway, and Sweden were combined. Patients ≥70 years with resectable gastric cancer (cT1-4a, cN0-2, cM0), diagnosed between 2004 and 2014 were included. Resection rates, administration of chemotherapy (irrespective of surgery), and relative survival within a country according to stage were determined. Results: Overall, 6698 patients were included. The percentage of operated patients was highest in Belgium and lowest in Sweden for both stage II (74% versus 56%) and stage III disease (57% versus 25%). For stage III, chemotherapy administration was highest in Belgium (44%) and lowest in Sweden (2%). Three year relative survival for stage I, II, and III disease in Belgium was 67.8% (95% CI:62.8–72.6), 41.2% (95% CI:37.3–45.2), 17.8% (95% CI:12.5–24.0), compared with 56.7% (95% CI:51.5–61.7), 31.3% (95% CI:27.6–35.2), 8.2% (95% CI:4.4–13.4) in Sweden. There were no significant differences in treatment strategies of patients with stage I disease. Conclusion: Substantial treatment differences are observed across North European countries for patients with stages II and III resectable gastric cancer aged 70 years or older. In the present comparison, treatment strategies with a higher proportion of patients undergoing surgery seemed to be associated with higher survival rates for patients with stages II or III disease.

(Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
70 years, Elderly, Gastric cancer, Resectable, Survival, Treatment
in
European Journal of Surgical Oncology
volume
44
issue
12
pages
1982 - 1989
publisher
Elsevier
external identifiers
  • scopus:85055028891
ISSN
0748-7983
DOI
10.1016/j.ejso.2018.09.014
language
English
LU publication?
yes
id
a63a557e-2ff1-49f8-81e7-025bbaa7f00d
date added to LUP
2018-10-29 15:57:30
date last changed
2019-02-20 11:33:44
@article{a63a557e-2ff1-49f8-81e7-025bbaa7f00d,
  abstract     = {<p>Background: As older gastric cancer patients are often excluded from randomized clinical trials, the most appropriate treatment strategy for these patients remains unclear. The current study aimed to gain more insight in treatment strategies and relative survival of older patients with resectable gastric cancer across Europe. Methods: Population-based cohorts from Belgium, Denmark, The Netherlands, Norway, and Sweden were combined. Patients ≥70 years with resectable gastric cancer (cT1-4a, cN0-2, cM0), diagnosed between 2004 and 2014 were included. Resection rates, administration of chemotherapy (irrespective of surgery), and relative survival within a country according to stage were determined. Results: Overall, 6698 patients were included. The percentage of operated patients was highest in Belgium and lowest in Sweden for both stage II (74% versus 56%) and stage III disease (57% versus 25%). For stage III, chemotherapy administration was highest in Belgium (44%) and lowest in Sweden (2%). Three year relative survival for stage I, II, and III disease in Belgium was 67.8% (95% CI:62.8–72.6), 41.2% (95% CI:37.3–45.2), 17.8% (95% CI:12.5–24.0), compared with 56.7% (95% CI:51.5–61.7), 31.3% (95% CI:27.6–35.2), 8.2% (95% CI:4.4–13.4) in Sweden. There were no significant differences in treatment strategies of patients with stage I disease. Conclusion: Substantial treatment differences are observed across North European countries for patients with stages II and III resectable gastric cancer aged 70 years or older. In the present comparison, treatment strategies with a higher proportion of patients undergoing surgery seemed to be associated with higher survival rates for patients with stages II or III disease.</p>},
  author       = {Claassen, Y. H.M. and Dikken, J. L. and Hartgrink, H. H. and de Steur, W. O. and Slingerland, M. and Verhoeven, R. H.A. and van Eycken, E. and de Schutter, H. and Johansson, J. and Rouvelas, I. and Johnson, E. and Hjortland, G. O. and Jensen, L. S. and Larsson, H. J. and Allum, W. H. and Portielje, J. E.A. and Bastiaannet, E. and van de Velde, C. J.H.},
  issn         = {0748-7983},
  keyword      = {70 years,Elderly,Gastric cancer,Resectable,Survival,Treatment},
  language     = {eng},
  number       = {12},
  pages        = {1982--1989},
  publisher    = {Elsevier},
  series       = {European Journal of Surgical Oncology},
  title        = {North European comparison of treatment strategy and survival in older patients with resectable gastric cancer : A EURECCA upper gastrointestinal group analysis},
  url          = {http://dx.doi.org/10.1016/j.ejso.2018.09.014},
  volume       = {44},
  year         = {2018},
}