[The prognostic relevance of age and comorbidity in patients with resected gastric cancer].
BACKGROUND
In spite of decreasing incidence rates, gastric carcinomas still belong to the top ten causes of tumour death in Germany. The aim of our study was to analyse the influence of age and comorbidity on the prognosis in patients with gastric cancer.


METHODS
One-hundred and seventy-five consecutive patients with gastric cancer resected under curative intentions were included in this study. The comorbidity (Com) was evaluated with the Charlson comorbidity index (CCI) classifying four different grades of severity (CCI grade 0 = no Com, I = light Com, II = middle Com, III = severe Com). For each decade more than fifty years of age, one point was added for the calculation of the age-adjusted CCI grade. The prognosis was analysed with uni- and multivariate methods.


RESULTS
Sixty-two percent of the 175 patients were males. The median age of all patients was 67 years; 18 % were younger than 50 years, 40 % between 51 and 70 years and 42 % were older than 70 years. The frequencies of comorbidity were as follows: CCI grade 0 = 32 %, I = 46 %, II = 18 % and III = 4 %. The 5-years survival rate (5y-SR) for all patients was 39 %. The univariate analysis of the prognosis showed a significant -influence (p < 0.001) of pT, pN, pM and R categories, but no significant results for age and comorbidity. However, the age-adjusted CCI grades demonstrated significantly different prognoses both in the univariate (p < 0.05) and in the multivariate analyses (p < 0.001) including the UICC stages. Patients between 50 and 70 years -without or with only minor comorbidity had the best prognosis (5y-SR = 55 %). In contrast, young patients without comorbidity had a worse prognosis comparable with that of older patients with comorbidity.


CONCLUSIONS
The combination of high age and comorbidity are -together with the UICC stage the most relevant prognostic factors in patients with resected gastric cancer.
Bollschweiler
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E
Klinik und Poliklinik für Visceral- und Gefässchirurgie, Universität zu Köln, Deutschland. Elfriede.Bollschweiler@uk-koeln.de
Breckheimer
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Mönig
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SP
Hölscher
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AH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery; D013997:Time Factors