Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung, Korea.
PLoS One. 2019 Aug 1;14(8):e0220660. doi: 10.1371/journal.pone.0220660. eCollection 2019.
Controversies exist regarding the impact of age on gastric cancer-related mortality according to cancer stage. In our prospective cohort study, we evaluated the impact of age on stage-specific mortality in patients with gastric cancer. Between 2002 and 2006, patients with newly diagnosed gastric cancer were recruited from two university-affiliated hospitals in Korea. Follow-up data were updated regularly based on medical records and telephone surveys. Patients were classified into four subgroups according to age: <50, 50-59, 60-69, and 70-79 years. A total of 448 patients were followed up for 81.6 months (interquartile range, 25.0-139.3 months). The number of patients with stage I, II, III, and IV disease was 247, 74, 88, and 39, respectively. Overall, age was an independent risk factor for gastric cancer-specific mortality (hazard ratio [HR], [95% confidence interval (CI)]: 1.53 [0.91-2.57], 1.88 [1.21-2.91], and 2.64 [1.69-4.14] in the 50-59, 60-69, and 70-79 years groups, respectively, with the <50 years group as reference). In patients with stage I and II gastric cancer, the 70-79 years group was associated with a significantly higher rate of cancer-specific mortality than the <50 years group (stage I: HR [95% CI], 9.55 [2.11-43.12]; stage II: HR [95% CI], 7.17 [2.32-22.18]). However, age was not an independently associated factor for cancer-specific mortality in patients with stage III and IV gastric cancer. Although age was an independent risk factor for gastric cancer-related mortality in patients with gastric cancer, its impact may differ depending on the stage of cancer.
关于癌症分期对胃癌相关死亡率的影响，存在争议。在我们的前瞻性队列研究中，我们评估了年龄对胃癌患者特定分期死亡率的影响。2002 年至 2006 年期间，从韩国的两家大学附属医院招募了新诊断为胃癌的患者。根据病历和电话调查定期更新随访数据。根据年龄将患者分为四组：<50 岁、50-59 岁、60-69 岁和 70-79 岁。共有 448 例患者随访 81.6 个月（四分位间距，25.0-139.3 个月）。I 期、II 期、III 期和 IV 期疾病患者分别为 247、74、88 和 39 例。总体而言，年龄是胃癌特异性死亡率的独立危险因素（危险比 [HR]，[95%置信区间（CI）]：50-59 岁组为 1.53 [0.91-2.57]，60-69 岁组为 1.88 [1.21-2.91]，70-79 岁组为 2.64 [1.69-4.14]，<50 岁组为参考）。在 I 期和 II 期胃癌患者中，70-79 岁组的胃癌特异性死亡率明显高于<50 岁组（I 期：HR [95%CI]，9.55 [2.11-43.12]；II 期：HR [95%CI]，7.17 [2.32-22.18]）。然而，年龄并不是 III 期和 IV 期胃癌患者胃癌特异性死亡率的独立相关因素。尽管年龄是胃癌患者胃癌相关死亡率的独立危险因素，但它的影响可能因癌症分期而异。
