Time trends in diagnostic strategy, treatment, and prognosis of gastric cancer in the elderly: a population based study.
The impact of changes in diagnostic strategies for gastric cancer and attitudes towards surgery in elderly patients is not known. A population-based series of 842 gastric cancers diagnosed between 1976 and 1993 in patients aged 70 and older in Côte-dOr, France, was used to establish trends in diagnostic strategy, treatment, and prognosis. The use of endoscopy alone increased from 3% (1976-78) to 81% (1991-93). This trend was initially associated with a decrease in the use of x-ray alone, then with a decrease in the use of both x-ray and endoscopy. The proportion of resection for cure increased from 26% during 1976-78 to 43% during 1991-93 (P < 0.001). The proportion of cancers not extending beyond the gastric wall increased from 12% to 24% (P < 0.05). Operative mortality decreased from 38.7% (1976-78) to 13.3% (1991-93) and the corresponding 3-year crude survival rate rose from 7% to 18%. Improvements in the care of gastric cancer in elderly patients have been achieved, but further progress is warranted.
Benhamiche
A M
AM
Registre des Cancers Digestifs (INSERM CRI 9505), Faculté de Médecine, Dijon, France.
Faivre
J
J
Tazi
A M
AM
Couillault
C
C
Villing
A L
AL
Rat
P
P
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D016001:Confidence Intervals; D005260:Female; D005602:France / Q000453:epidemiology; D005743:Gastrectomy / Q000379:methods / Q000639:trends*; D005773:Gastroscopy / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D009367:Neoplasm Staging; D016017:Odds Ratio; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D015996:Survival Rate