399P - Long-term outcomes of patients with gastric cancer who received the best supportive care without any anticancer treatment

Background

Due to the lack of studies on unfit patients with gastric cancer (GC) who did not receive any aggressive cancer treatment—best supportive care (BSC) cases—their long-term prognosis remains unclear, especially for those harboring potentially curable disease (clinical stage [cStage] I–III). Therefore, clinicians sometimes have trouble answering unfit patients or their caregivers when asked questions such as “How long will I live without any anticancer treatment?”. Hence, we conducted this observational study to capture the real-world data of baseline characteristics, provided supportive care, and long-term outcomes for BSC cases.

Methods

Consecutive clinical records of patients with GC diagnosed at Steel Memorial Muroran Hospital (SMMH) from January 2017 to December 2021 were collected and analyzed. We conducted this study with the approval of the Institutional Review Board of SMMH (#J230103). The primary outcome of this study is overall survival (OS).

Results

Of 481 patients diagnosed with GC, 91 (18.9%) were BSC cases; their median age was 85 (range: 46–96) years, and 75.8% were male. BSC cases showed a very high risk of receiving aggressive cancer treatment with a median Age-Adjusted Charlson Comorbidity Index score of 7 and a G-8 score of 7. The median OS for all patients was 3.9 months (95% confidence interval [CI]: 3.0–5.4). The median OS was 12.4, 8.3, and 2.5 months for cStage I, II–III, and IV, respectively. Patients with potentially curable GC (cStage I–III) had significantly longer OS than those with incurable disease (cStage IV), with a hazard ratio for death of 0.29 (95% CI: 0.18–0.47, p<0.0001). The percentage of death by GC in a total number of deaths also increased with increasing stage. Pneumonia and heart failure were the most common cause of death among cases who died other than GC. After diagnosis, cStage I patients were more likely to prefer to stay where they had lived (nursing homes or their own house), while more advanced stage patients chose hospice.

Conclusions

The median OS of BSC cases in poor general condition was ∼1 year for cStage I, 8 months for cStage II–III, and < 3 months for cStage IV.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

K. Takada: Financial Interests, Personal, Invited Speaker: Eisai, Janssen, Chugai, Ono, Otsuka, Daiichi Sankyo, Sanofi. All other authors have declared no conflicts of interest.