Postoperative chemotherapy in elderly patients with advanced gastric cancer

Background/Aims: The definitive efficacy of postoperative chemotherapy in e lderly patients with advanced gastric cancer has not been established. The aim of this study is to evaluate prognosis in elderly patients with advance d gastric cancer and the effect of postoperative chemotherapy on prognosis. Methodology: Fifty-three patients, 75 years of age or older who underwent c urative surgery for advanced gastric cancer were divided into 14 patients w ith postoperative chemotherapy (chemotherapy group) and 39 patients without postoperative chemotherapy (control group). Chemotherapy regimens were as follows: oral 5-FU alone (n=11), intravenous mitomycin plus 5-FU: MF (n=2), and MF plus oral 5-FU (n=1). No prior chemotherapy or radiation was given. Results: There were no significant differences of clinical and pathological backgrounds between the two groups. The rate of death due to recurrent car cinoma was 50.0% in the chemotherapy group and 43.6% in the control group, the difference being insignificant. Although the median survival time of th e chemotherapy group (40.4 months) was longer than in the control group (31 .7 months), a significant difference did not exist between the groups. The 1-, 3-, and 5-year survival rates did not significantly differ between the chemotherapy group versus the control group, 85.7% versus 82.1%, 42.9% vers us 51.3%, and 35.7% versus 46.2%, respectively. Conclusions: Postoperative chemotherapy did not contribute to prolong survi val in elderly patients with advanced gastric cancer mainly because the inc idence of recurrent carcinoma was not reduced.