Abstract 167P
Background
Older patients with gastric cancer have a poorer prognosis compared to younger patients. Early recurrence within two years after surgery is a known poor prognostic factor for patients who have undergone curative surgery. However, the factors associated with early recurrence in older patients with gastric cancer remain unclear. This study aims to investigate the factors associated with early recurrence in older patients with stage II/III gastric cancer who have received curative gastrectomy.
Methods
Patients older than 65 years, diagnosed with stage II/III gastric cancer, and who received curative surgery at our institute between January 2009 and December 2020 were retrospectively reviewed. Clinical data from 237 consecutive patients were analyzed. Clinical characteristics were compared between patients with and without early recurrence. Logistic regression was used to analyze factors associated with early recurrence.
Results
Of the 237 patients, 103 experienced recurrence after surgery, and 72 of these (69.9%) had early recurrence within two years. The median overall survival was 16.5 months for patients with early recurrence. Compared to patients without early recurrence, those with early recurrence had larger tumors, more advanced stages, higher lymph node ratios, more lymphovascular invasion, more perineural invasion, higher carcinoembryonic antigen levels, higher carbohydrate antigen 19-9 levels, more positive surgical margins, a higher proportion of total gastrectomy, and less adjuvant chemotherapy. Multivariate analysis showed that a lymph node ratio > 0.17 was an independent risk factor for early recurrence (odds ratio, 5.63; 95% confidence interval, 2.16-14.68; P < 0.001). Adjuvant chemotherapy was associated with a decreased risk of early recurrence (odds ratio, 0.38; 95% confidence interval, 0.16-0.93; P = 0.03).
Conclusions
A lymph node ratio > 0.17 was associated with a higher risk of early recurrence within two years in older patients with stage II/III gastric cancer. Adjuvant chemotherapy might reduce the risk of early recurrence. Further prospective studies are needed to validate these findings.
Clinical trial identification
Editorial acknowledgement
During the preparation of this work, the author(s) used OpenAI's ChatGPT in order to assist with the writing and editing process. After using this tool, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication.
Legal entity responsible for the study
The authors.
Funding
Taichung Veterans General Hospital.
Disclosure
All authors have declared no conflicts of interest.