Multivariate analysis of prognostic factors in patients aged 65 years and over with advanced gastric cancer / 中华老年医学杂志

ABSTRACT

Objective To analyze the effects of different therapies on patient survival,to explore the related prognostic factors in elderly patients with advanced gastric cancer,and to provide recommendations for the treatment of such patients.Methods Retrospective analysis was conducted on 146 elderly patients with advanced gastric cancer hospitalized from January 2009 to October 2013 in Yixing People's Hospital of Jiangsu Province.Detailed clinical data were recorded,and patients were followed up during the total survival time.Univariate analysis with the Log rank test and multivariate analysis with the COX proportional hazard model were utilized to examine the related prognostic factors in elderly patients with advanced gastric cancer.Results The 1-,2,3-year survival rates of t46 elderly patients with advanced gastric cancer were 33.6 ％,11.0 ％,and 2.1 ％,respectively,and the median survival time was 10.3 months.The Log-rank test showed that Karnofsky (KPS) score,differentiation degree,number of metastatic sites,malignant serous effusion,chemotherapy,and traditional Chinese medicine (TCM) were associated with the prognosis of elderly patients with advanced GC (all P＜0.05).Multivariate analysis by the COX proportional hazard model showed that KPS score (HR=1.575,95％ CI1.094 2.267,P=0.015),differentiation degree (HR=0.499,95％CI0.340-0.732,P＜0.001),malignant serous effusion (HR=0.516,95％ CI0.356-0.748,P＜ 0.001),chemotherapy (HR=1.669,95％ CI1.185 2.351,P=0.003),and TCM (HR=1.793,95％ CI1.237-2.600,P=0.002) were independent factors related to the prognosis of elderly patients with advanced GC.Conclusions The prognosis of elderly patients with advanced gastric cancer is poor,especially for patients with a low KPS score,a poor differentiation degree,or malignant serous effusion.Chemotherapy and TCM can improve the prognosis.