Clinical Outcomes in Advanced Gastric Cancer Among Patients Aged ≥80 Years Treated With Chemotherapy

The proportion of older patients with advanced gastric cancer (AGC) is increasing, yet evidence regarding the clinical impact of very advanced age (≥80 years) on systemic chemotherapy efficacy and safety remains limited. This study evaluated real-world treatment patterns and outcomes across age groups and assessed the prognostic significance of advanced age in patients with AGC.

Patients with unresectable or recurrent gastric or gastroesophageal junction adenocarcinomas who received first-line systemic chemotherapy between 2009 and 2024 were included through a retrospective chart review and stratified into three age groups: <70, 70-79, and ≥80 years old. Overall survival (OS) was the primary endpoint; secondary endpoints included time-to-treatment failure (TTF), objective response rate (ORR), and disease control rate (DCR).

In total, 322 patients were included. The median OS, TTF, ORR, and DCR did not differ significantly across age groups. Although age ≥80 years was associated with worse OS in univariate analysis, it was not an independent prognostic factor. Patients aged ≥80 years received fewer subsequent treatment lines and more frequently discontinued first-line therapy because of toxicity.

Advanced age was not an independent prognostic factor in AGC. Despite reduced treatment continuity and higher toxicity-related discontinuation in patients of advanced age, antitumor activity was similar across all age groups, supporting the use of systemic chemotherapy with careful patient selection and toxicity monitoring.