caa a22 4500 445333057 CHVBK 20180317142743.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1245/s10434-010-1215-9 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1215-9 Guideline Recommended Gastric Cancer Care in the Elderly: Insights into the Applicability of Cancer Trials to Real World [Elektronische Daten] [Vikas Dudeja, Elizabeth Habermann, Wei Zhong, Todd Tuttle, Selwyn Vickers, Eric Jensen, Waddah Al-Refaie] Background: Given the underrepresentation of older persons in cancer trials, the association between increasing age and receipt of recommended gastric cancer care in the United States was examined. Materials and Methods: Using the 1998-2006 SEER database, 8637 Medicare-eligible patients, aged ≥65years who underwent gastrectomy for nonmetastatic gastric adenocarcinoma were identified. Multivariate analyses was used to assess the effect of increasing age on receipt of recommended gastric cancer care (adequate lymph node evaluation [≥15 lymph nodes] and adjuvant radiation therapy for AJCC Ib-IVM0) and cancer-specific mortality controlling for covariates. Results: While 61% of gastric cancer operations were performed in patients ≥65years, less than 30% received adequate lymphadenectomy or adjuvant radiation therapy. Older patients were less likely to receive adequate nodal evaluation and adjuvant radiotherapy (P <0.0001). These findings persisted on multivariate analyses. Older age was also associated with worse cancer-specific mortality. Because an age-tumor location interaction for cancer mortality (P=0.047) was observed, stratified analyses were performed which showed that the adverse effect of older age on cancer-specific mortality was augmented in proximal gastric cancers. Conclusions: This population-based study showed significant age-based variations in gastric cancer care. These results should encourage assessment of generalizability of gastric cancer trials to this expanding population of elderly in the era of comparative effectiveness research. Society of Surgical Oncology, 2010 Dudeja Vikas Department of Surgery, The University of Minnesota, Minneapolis, MN, USA aut Habermann Elizabeth Department of Surgery, The University of Minnesota, Minneapolis, MN, USA aut Zhong Wei Department of Surgery, The University of Minnesota, Minneapolis, MN, USA aut Tuttle Todd Department of Surgery, The University of Minnesota, Minneapolis, MN, USA aut Vickers Selwyn Department of Surgery, The University of Minnesota, Minneapolis, MN, USA aut Jensen Eric Department of Surgery, The University of Minnesota, Minneapolis, MN, USA aut Al-Refaie Waddah Division of surgical oncology, Department of Surgery, Mayo Mail Code 195, The University of Minnesota and Minneapolis Veteran Affairs Medical Center, Minneapolis, MN, USA aut Annals of Surgical Oncology Springer-Verlag 18/1(2011-01-01), 26-33 1068-9265 18:1<26 2011 18 10434 https://doi.org/10.1245/s10434-010-1215-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1215-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Dudeja Vikas Department of Surgery, The University of Minnesota, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Habermann Elizabeth Department of Surgery, The University of Minnesota, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Zhong Wei Department of Surgery, The University of Minnesota, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Tuttle Todd Department of Surgery, The University of Minnesota, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Vickers Selwyn Department of Surgery, The University of Minnesota, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Jensen Eric Department of Surgery, The University of Minnesota, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Al-Refaie Waddah Division of surgical oncology, Department of Surgery, Mayo Mail Code 195, The University of Minnesota and Minneapolis Veteran Affairs Medical Center, Minneapolis, MN, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/1(2011-01-01), 26-33 1068-9265 18:1<26 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer