Abstract 3748
Background
Patients (pts) at the extremes of the age spectrum are often under-represented in gastric cancer trials (median age of inclusion was 56-62 years old (y/o) in major studies). Large population-based databases are useful to characterize the demographics, treatment patterns, and outcomes of these pts.
Methods
We obtained de-identified demographic, staging, and treatment information on gastric adenocarcinoma (GA) pts 18-90 y/o diagnosed between 2004-2013 from the National Cancer Database. The cohort was divided into young adults (YAs, 18-39 y/o), extreme elderly pts (EE, 75-90 y/o) and remaining pts into a middle age group (MA, 40-74 y/o). Differences amongst the groups were evaluated and compared using Pearson's chi-squared test.
Results
The total cohort included 118,417 pts: YAs (n = 3,997, 3.4%), MA (n = 77,292 65.3%), and EE (n= 37,128, 31.3%). Results are summarized as percentages in the table to reflect effect size given the large cohort. All differences amongst the groups were statistically significant (p 75 years old, a higher proportion of whom are not treated.
| YA | MA | EE | |
|---|---|---|---|
| Sex (N = 118,417) Male/Female | 52.8%/47.2% | 66.6%/33.4% | 58.1%/41.9% |
| Race (N = 115,372) White/Black/Asian | 72.0%/ 18.5%/ 9.5% | 76.6%/ 16.6%/ 6.8% | 80.9%/ 12.9%/ 6.1% |
| Ethnicity (N = 111,467) Hispanic/non-Hispanic | 29.6%/70.3% | 11.3%/88.7% | 7.2%/92.8% |
| Stage (N = 118,417) I/II/III/IV | 16.0%/10.5%/18.4%/55.2% | 22.9%/15.2%/21.1%/40.9% | 30.5%/16.0%/18.4%/35.1% |
| Grade (N = 94,326) 1/2/3 | 6.2%/13.9%/79.9% | 7.6%/26.9%/65.5% | 7.5%/32.4%/60.1% |
| Subtype (N = 11,110) Intestinal/diffuse | 30.3%/69.7% | 66.7%/33.3% | 80.1%/19.9% |
| Treatment (N = 82,765) Surgery Surgery + chemo Surgery + chemoRT None | 25.7% 23.6% 28.8% 21.8% | 34.6% 17.3% 27.6% 20.4% | 47.9% 7.2% 8.7% 36.2% |
Conclusions
Differences exist between age extremes in GA patients compared to those traditionally represented in landmark trials including demographics, stage of presentation, histologic subtype, and treatment utilization. Further investigation is warranted to determine the effects of these differences on outcome.
Clinical trial identification
Legal entity responsible for the study
This study is a retrospective review. No legal entities were involved in the conduct of this study.
Funding
Mount Sinai School of Medicine
Disclosure
All authors have declared no conflicts of interest.