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Increased use of chemotherapy for gastric cancer has not extended OS
OS rates for patients with metastatic noncardia gastric cancer remained stable in the past two decades despite a considerable increase in the use of chemotherapy for those patients, according to results of a population-based study.
The analysis included 4,797 patients enrolled in the Eindhoven Cancer Registry in the Netherlands.
The proportion of patients who presented with metastatic gastric cancer increased from 24% in 1990 to 44% in 2011 (P<.0001). The use of palliative chemotherapy among this patient population increased from 5% to 36% during this time period, with “a strong increase” after 2006 (P<.0001), the researchers wrote.
Despite the increased use of chemotherapy, median OS remained relatively stable during the study period, increasing from 15 weeks (95% CI, 11.9-17.7) in 1990 to 17 weeks (95% CI, 15-20) in 2011.
Researchers determined patients aged younger than 50 years (OR=3.9; P<.001) and those aged 50 to 59 years (OR=1.17; P=.01) most often received chemotherapy. Patients aged 70 to 79 years (OR=.3; P<.001), as well as those aged 80 years or older (OR=.02; P<.001), were less likely to undergo chemotherapy.
Patients with a high socioeconomic status were more likely to undergo chemotherapy (OR=1.7; P=.01), whereas those with comorbidity (OR=0.6; P=.03), linitis plastica (OR=0.5; P=.03) and multiple distant metastases (OR=0.5; P=.01) were less likely to undergo chemotherapy.
Chemotherapy usage varied from 9% to 27% based on hospital setting, the researchers wrote.
“Identification of the subgroup of patients which benefits from palliative chemotherapy is of utmost importance to avoid unnecessary treatment,” the researchers wrote.
Disclosure: See the study for a full list of relevant financial disclosures.