Gastrointestinal carcinoma--are there age-related differences in tumor behavior?

Among the gastric cancers, the percentage of diffuse carcinomas decreases with increasing age, while the incidence of the intestinal type increases markedly (up to 50 years 29.6%, older than 70 years 61.5%). Accordingly, in patients older than 70, gastric carcinomas limited to the antrum are seen significantly more frequently (32.5%) than in younger patients (21.1%). In patients aged 70 years or less, the rectum is more frequently affected than the colon (ratio 1.41:1), than is the case in older patients (1.17:1). With respect to stage distribution and the pTNM classification, colorectal carcinomas and gastric carcinomas show only small age-related differences. The prognosis of both carcinomas is independent of age when the survival rates are corrected for age, post-operative mortality is excluded, and only patients with identical stages are compared. In patients older than 70, cancer is not less aggressive, but, as a result of the limitations of therapeutic possibilities, and greater side effects of treatment, is more dangerous than in younger patients.