ESMO Asia Virtual Congress 2020

Abstract 132P

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.