Clinicopathological features and prognoses in younger and older patients with gastric cancer

Figures & data

Figure 1 Age composition of 1,990 GC patients.

Abbreviation: GC, gastric cancer.

Table 1 Clinicopathological features of younger and older GC patients

Factors	Younger (n=112)	Older (n=358)	χ^2	P-value
Gender			23.512	<0.001
Male	59 (52.7)	274 (76.5)
Female	53 (47.3)	84 (23.5)
Tumor depth			0.757	0.86
T1	7 (6.3)	17 (4.7)
T2	6 (5.3)	25 (7.0)
T3	33 (29.5)	102 (28.5)
T4	66 (58.9)	214 (59.8)
Lymph nodes			6.153	0.104
N0	20 (17.9)	93 (26.0)
N1	27 (24.1)	61 (17.0)
N2	24 (21.4)	93 (26.0)
N3	41 (36.6)	111 (31.0)
Distant metastasis			2.42	0.085
M0	94 (83.9)	320 (89.4)
M1	18 (16.1)	38 (10.6)
AJCC stage			3.463	0.326
I	5 (4.5)	25 (7.0)
II	30 (26.8)	89 (24.9)
III	59 (52.7)	206 (57.5)
IV	18 (16.0)	38 (10.6)
Radicality			0.466	0.495
R0	85 (75.9)	260 (72.6)
R1 or R2	27 (24.1)	98 (27.4)
Tumor size (cm)			0.687	0.407
≤6	70 (62.5)	239 (66.8)
>6	42 (37.5)	119 (33.2)
Tumor location			6.365	0.095
Upper	12 (10.7)	61 (17.0)
Middle	21 (18.8)	64 (17.9)
Low	64 (57.1)	208 (58.1)
Whole	15 (13.4)	25 (7.0)
MLNR			0.022	0.912
≤31.5%	67 (59.8)	217 (60.6)
>31.5%	45 (40.2)	141 (39.4)
Differentiationa			17.662	<0.001
Differentiated	6 (5.4)	83 (23.2)
Undifferentiated	106 (94.6)	275 (76.8)
Ascites			2.338	0.156
No	105 (93.8)	347 (96.9)
Yes	7 (6.2)	11 (3.1)
CA19–9 (U/mL)			4.76	0.029
Negative	96 (85.7)	272 (76.0)
Positive	16 (14.3)	86 (24.0)
CEA (ng/mL)			11.865	0.001
Negative	101 (90.2)	268 (74.9)
Positive	11 (9.8)	90 (25.1)
Hb (g/L)			1.61	0.204
Positive	60 (53.6)	216 (60.3)
Negative	52 (46.4)	142 (39.7)

Note:

a Grades 1 and 2 were differentiated, and grades 3 and 4 were undifferentiated.

Abbreviations: AJCC, American Joint Committee on Cancer; CA, carbohydrate antigen; CEA, carcinoembryonic antigen; GC, gastric cancer; Hb, hemoglobin; MLNR, metastasis lymph node rate.

Figure 2 Comparison of overall survival between younger and older gastric cancer patients.

Abbreviation: Cum, cumulative.

Table 2 Survival analysis of the 470 younger and older GC patients

Parameter	Univariate analysis			Multivariate analysis
	β	HR (95% CI)	P-value	β	HR (95% CI)	P-value
Age (younger/older)	0.513	1.671 (1.296–2.153)	<0.001	0.598	1.818 (1.383–2.391)	<0.001
Gender (male/female)	−0.170	0.843 (0.675–1.054)	0.134	−0.020	0.980 (0.766–1.255)	0.876
Tumor depth (T1/T2/T3/T4)	0.372	1.451 (1.282–1.643)	<0.001	−0.021	0.979 (0.810–1.183)	0.825
Lymph nodes (N0/N1/N2/N3)	0.495	1.640 (1.493–1.801)	<0.001	0.213	1.237 (1.029–1.4870)	0.024
Distant metastasis (M0/M1)	1.492	4.447 (3.216–6.150)	<0.001	0.458	1.581 (0.930–2.689)	0.091
AJCC stage (I/II/III/IV)	0.915	2.497 (2.131–2.927)	<0.001	0.394	1.483 (1.032–2.131)	0.033
Radicality (R0/R1 or R2)	1.179	3.252 (2.564–4.126)	<0.001	0.484	1.622 (1.211–2.174)	0.001
Tumor size (≤6 cm/>6 cm)	0.794	2.212 (1.786–2.740)	<0.001	0.452	1.572 (1.237–1.999)	<0.001
Tumor location (upper/middle/low/whole)	−0.052	0.950 (0.836–1.078)	0.424	−0.047	0.954 (0.843–1.081)	0.461
MLNR (≤31.5%/>31.5%)	1.049	2.856 (2.298–3.549)	<0.001	0.304	1.355 (0.978–1.877)	0.068
Differentiation (differentiated/undifferentiated)	0.177	1.194 (0.935–1.524)	0.156	0.012	1.012 (0.780–1.314)	0.929
Ascites (no/yes)	0.382	1.466 (0.857–2.506)	0.162	−0.219	0.803 (0.451–1.430)	0.456
CA19–9 (negative/positive)	0.364	1.439 (1.136–1.823)	0.003	−0.007	0.993 (0.771–1.279)	0.958
CEA (negative/positive)	0.346	1.423 (1.114–1.792)	0.004	0.125	1.133 (0.877–1.462)	0.339
Hb (≤130/>130) (g/L)	−0.168	0.846 (0.691–1.035)	0.104	−0.156	0.855 (0.687–1.065)	0.163

Abbreviations: AJCC, American Joint Committee on Cancer; CA, carbohydrate antigen; CEA, carcinoembryonic antigen; CI, confidence interval; GC, gastric cancer; Hb, hemoglobin; HR, hazards ratio; MLNR, metastasis lymph node rate.

Table 3 Survival analysis of the 112 younger GC patients

Parameter	Univariate analysis			Multivariate analysis
	β	HR (95% CI)	P-value	β	HR (95% CI)	P-value
Gender (male/female)	−0.192	0.825 (0.521–1.307)	0.413	0	1.000 (0.573–1.746)	0.999
Tumor depth (T1/T2/T3/T4)	0.415	1.514 (1.142–2.008)	0.004	0.287	1.333 (0.820–2.165)	0.246
Lymph nodes (N0/N1/N2/N3)	0.636	1.890 (1.465–2.438)	<0.001	0.536	1.710 (1.007–2.903)	0.047
Distant metastasis (M0/M1)	1.524	4.590 (2.266–9.297)	<0.001	1.119	3.063 (0.632–14.836)	0.164
AJCC stage (I/II/III/IV)	0.966	2.629 (1.799–3.842)	<0.001	−0.198	0.821 (0.278–2.421)	0.720
Radicality (R0/R1 or R2)	1.502	4.492 (2.364–8.538)	<0.001	0.597	1.816 (0.683–4.830)	0.232
Tumor size (≤6 cm/>6 cm)	0.725	2.065 (1.266–3.367)	0.004	0.415	1.515 (0.838–2.740)	0.169
Tumor location (upper/middle/low/whole)	0.010	1.010 (0.727–1.403)	0.952	−0.129	0.879 (0.629–1.228)	0.450
MLNR (≤31.5%/>31.5%)	1.163	3.199 (1.941–5.274)	<0.001	0.154	1.166 (0.507–2.680)	0.718
Differentiation (differentiated/undifferentiated)	0.244	1.276 (0.464–3.508)	0.637	−0.052	0.950 (0.286–3.148)	0.933
Ascites (no/yes)	0.146	1.157 (0.415–3.231)	0.780	−1.088	0.337 (0.071–1.608)	0.173
CA19–9 (negative/positive)	0.140	1.150 (0.601–2.200)	0.673	0.035	1.036 (0.496–2.162)	0.926
CEA (negative/positive)	0.611	1.843 (0.938–3.622)	0.076	0.628	1.873 (0.680–5.164)	0.225
Hb (negative/positive)	0.444	1.558 (0.964–2.518)	0.070	0.364	1.439 (0.829–2.497)	0.196

Abbreviations: AJCC, American Joint Committee on Cancer; CA, carbohydrate antigen; CEA, carcinoembryonic antigen; CI, confidence interval; GC, gastric cancer; Hb, hemoglobin; HR, hazards ratio; MLNR, metastasis lymph node rate.

Table 4 Survival analysis of the 358 older GC patients

Parameter	Univariate analysis			Multivariate analysis
	β	HR (95% CI)	P-value	β	HR (95% CI)	P-value
Gender (male/female)	−0.003	0.997 (0.767–1.295)	0.980	0.031	1.032 (0.780–1.365)	0.826
Tumor depth (T1/T2/T3/T4)	0.360	1.433 (1.247–1.648)	<0.001	−0.110	0.896 (0.722–1.112)	0.319
Lymph nodes (N0/N1/N2/N3)	0.492	1.635 (1.479–1.807)	<0.001	0.169	1.185 (0.965–1.453)	0.105
Distant metastasis (M0/M1)	1.563	4.772 (3.306–6.888)	<0.001	0.296	1.345 (0.745–2.426)	0.325
AJCC stage (I/II/III/IV)	0.950	2.586 (2.167–3.087)	<0.001	0.528	1.695 (1.141–2.517)	0.009
Radicality (R0/R1 or R2)	1.097	2.995 (2.317–3.882)	<0.001	0.467	1.595 (1.164–2.186)	0.004
Tumor size (≤6 cm/>6 cm)	0.850	2.339 (1.841–2.972)	<0.001	0.481	1.618 (1.233–2.122)	0.001
Tumor location (upper/middle/low/whole)	−0.046	0.955 (0.833–1.095)	0.510	−0.069	0.934 (0.811–1.075)	0.339
MLNR (≤31.5%/>31.5%)	1.045	2.842 (2.229–3.624)	<0.001	0.291	1.337 (0.930–1.923)	0.116
Differentiation (differentiated/undifferentiated)	0.311	1.364 (1.055–1.765)	0.018	0.038	1.038 (0.791–1.364)	0.786
Ascites (no/yes)	0.699	2.012 (1.069–3.787)	0.030	0.091	1.095 (0.557–2.151)	0.792
CA19–9 (negative/positive)	0.367	1.443 (1.116–1.867)	0.005	−0.009	0.991 (0.748–1.3130)	0.949
CEA (negative/positive)	0.225	1.253 (0.969–1.619)	0.085	0.090	1.094 (0.834–1.436)	0.517
Hb (negative/positive)	−0.374	0.688 (0.547–0.865)	0.001	−0.270	0.764 (0.594–0.982)	0.035

Abbreviations: AJCC, American Joint Committee on Cancer; CA, carbohydrate antigen; CEA, carcinoembryonic antigen; CI, confidence interval; GC, gastric cancer; Hb, hemoglobin; HR, hazards ratio; MLNR, metastasis lymph node rate.

Figure 3 Survival analysis of MLR and PNI in younger and older gastric cancer patients.

Abbreviations: Cum, cumulative; MLR, monocyte-to-lymphocyte ratio; PNI, prognostic nutritional index.

Table 5 Comparison of MLR, PNI, lymphocyte, monocyte and albumin between younger and older GC patients

Stage	Biomarker	Group	$\overline{x}\pm \mathrm{s}$	t	P-value
Stage I	MLR	Younger	0.220±0.051	−0.958	0.346
		Older	0.301±0.200
	PNI	Younger	55.250±4.226	1.071	0.293
		Older	51.340±7.860
	Albumin	Younger	45.100±4.009	0.909	0.371
		Older	42.390±6.364
Stage II	MLR	Younger	0.210±0.093	−1.909	0.059
		Older	0.290±0.206
	PNI	Younger	55.890±6.413	4.00	<0.001
		Older	49.330±8.156
	Albumin	Younger	46.050±4.974	4.228	<0.001
		Older	40.310±6.838
Stage III	MLR	Younger	0.240±0.110	−1.453	0.147
		Older	0.270±0.178
	PNI	Younger	51.500±7.369	2.201	0.029
		Older	49.000±7.760
	Albumin	Younger	42.090±6.032	2.423	0.016
		Older	39.850±6.317
Stage IV	MLR	Younger	0.300±0.191	−1.374	0.175
		Older	0.400±0.269
	PNI	Younger	51.760±6.901	2.711	0.009
		Older	45.350±8.803
	Albumin	Younger	43.390±5.820	2.678	0.010
		Older	38.230±7.115
All stages	MLR	Younger	0.240±0.123	−2.569	0.011
		Older	0.292±0.201
	PNI	Younger	52.883±7.140	4.730	<0.001
		Older	48.862±8.060
	Lymphocyte	Younger	1.880±0.716	1.241	0.215
		Older	1.780±0.751
	Monocyte	Younger	0.410±0.155	−1.649	0.100
		Older	0.440±0.174
	Albumin	Younger	43.490±5.845	5.078	<0.001
		Older	39.970±6.571

Abbreviations: GC, gastric cancer; MLR, monocyte-to-lymphocyte ratio; PNI, prognostic nutritional index.