Comparison Of Clinicopathological Characteristics And Prognosis Of Gastric Cancer Patients Among Different Age Groups

Objective:To investigate clinical features and prognosis of gastric cancer of different age groups.Methods:Retrospective analysis 1526 underwent surgery (radical or palliative) clinical data of patients with gastric cancer in our hospital from Jan 1995 to Dec 2004. Followed up 550 cases, According to different age groups were divided into 3 groups:A group:≤40 years of age; B group:＞40 years and＜70 years of age; C group:≥70 years. The whole group and the group's gender distribution, the main symptoms, tumor location, size, Borrmann type, pathological type, TNM stage, surgical treatment, the complication rate and survival situations were used for statistical analysis. Constitute the set of data was used to compare the number ofχ2 test, with P <0.05 as significant difference, calculated by Kaplan-Meier survival time, survival rate, draw survival curves, survival curves were compared with Log rank test.Results:Male patients were in the major parts (69.3%). The proportion of male in the C group (2.6:1)were more than that in B group (2.24:1) and A group (1.35:1), there was significant difference between the three groups (χ2=4.074, P=0.044). The patients with gastric cancer frequently had bellyache, abdominal distension and discomfort, there were significant difference between the three groups (x2=41.08, P<0.05). Most of tumors occurred at pyloric antrum, no significant difference between the three groups (χ2=9.10, P>0.05); Tumor sizes were mostly 2cm-5cm, no significant difference between the three groups (χ2=8.78, P>0.05); In the whole group, only the 13.2% were discovered in early gastric cancer, there was no significant difference between the three groups (χ2=5.28,P>0.05); The majority of advanced patients with gastric cancer belonged to Borrmann typeⅢ(57.47%), followed by typeⅡ(32.11%), typeⅣ(8.72%), and the most rare typeⅠ(1.69%), no significant difference between the three groups (χ2=11.31,P>0.05); Most of patients (75.95%) were the low/no differentiation tumor by pathological examination in the whole group. However, with age increasing, high/moderate differentiation ratio increases, A group 11.3%, B group 22.6%, C group 30.56%, there was significant difference between the three groups (χ2= 61.55,P<0.01); The majority of patients with gastric cancer belonged to TNM stageⅢ(38.14%) and stageⅣ(25.88), there was significant difference between the three groups (χ2= 6.88, P>0.25).The overall resection rate was 96.40%(radical resection of 81.13%, palliative resection of 15.27%), no significant difference between the three groups (χ2=5.85, P>0.25); Postoperative complications and perioperative mortality in the whole group were 3.80% and 0.72%, which increases with age, there were significant differences between the three groups (χ2= 18.15, P<0.01;χ2=12.00,P<0.01); The mean survival time for all patients was 33.82±1.15months, of which the A group was 43.03±6.41 months, B group was 33.30±1.32 months, C group was 33.49±2.41 months; The median survival time for all patients was 28.00±1.52 months, of which the A group was 38.00±7.72months, B group was 27.00±1.90 months, C group was 26.00±2.51 months; All patients 1,3,5-year survival rates were 97.9%,35.2%,12.1%, of which the A group 1,3,5-year survival rates were 100%,51.8%,17.3%, B group were 98.3%,36.4%,10.1%, C group were 92.1%,28.4%,16.8%. Comparison between the survival rates of each group by the Log rank test, no significant difference (χ2=2.469, P=0.291).Conclusion:Gastric cancer patients of different age groups in the gender distribution, clinical manifestations, pathological type, surgical complications and perioperative mortality are significant differences, but no significant differences in survival rate, tumor location, size, Borrmann type, early diagnosis, TNM stage and resection rate. So, gastric cancer patients of different age groups are not difference in nature. The prognosis of patients with surgical treatment of all age groups makes no significant difference, Surgery and early diagnosis are the important factors to determine the prognosis of gastric cancer patients.