132P - Impact of increasing age on cancer- and noncancer-specific mortality in patients with gastric cancer treated by radical surgery: A competing risk analysis

Background

To perform competing risk analysis and evaluate cancer- and noncancer-specific mortality in patients with gastric cancer after radical surgery.

Methods

A total of 5051 patients from our department (as training set) and a total of 7123 patients from the Surveillance, Epidemiology, and End Results (SEER) database (as validation set) were enrolled in the study. The cumulative incidence of cancer and noncancer-specific mortality was determined by univariate and multivariate competing risk analysis.

Results

The five-year cancer- and noncancer-specific cumulative incidence of death (CID) in the training set were 36.9% and 2.5%, respectively, which were significantly lower than that in the validation set (48.2% and 8.6%, respectively). Multivariable analysis showed that age, tumor site, tumor size and pTNM stage were independent predictors of gastric cancer-specific mortality and overall survival, whereas age was an independent predictor of gastric noncancer-specific mortality. Noncancer–specific CID surpassed cancer-specific CID for pTNM stage I patients after approximately 8 years of surgery, but never for stage II and III patients. Moreover, for stage I patients, the time point when noncancer–specific CID surpassed cancer-specific CID become earlier as age increasing, with only 3.5 years after surgery for patients more than 74 years of age.

Conclusions

Age is an independent predictor of gastric cancer- and noncancer specific mortality and overall survival for patients after radical surgery. For patients with stage I gastric cancer, noncancer-specific mortality is a significant competing event, with an increasing impact as age increases.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Scientific and Technological Innovation Joint Capital Projects of Fujian Province.

Disclosure

All authors have declared no conflicts of interest.