Propensity score matched analysis of impact of neoadjuvant chemotherapy on outcomes of locally advanced gastric cancer in elderly patients

In the USA, approximately half of newly diagnosed patients with gastric cancer (GC) are 75 years or older. A propensity score matched (PSM) National Cancer Database investigated the impact of neoadjuvant chemotherapy (NAC) on outcomes of elderly patients with locally advanced GC. After PSM, a total of 1958 patients were included in both groups (NAC versus no NAC).NAC utilization increased from 2013 to 019 (21.0% versus 42.7%; p for trend <0.001). On pathologic analysis, patients who received NAC were more likely to have ≥ 16 lymph nodes evaluated and negative resection margins. Patients who received NAC were less likely to experience 30-day mortality after resection (NAC 4.1% versus no NAC 7.1%). Receipt of NAC was associated with improved 5-year OS rate (36.9% versus 30.5%) compared with patients who underwent upfront surgery (p=0.01). The authors conclude that receipt of NAC was associated with improved oncological outcomes among elderly patients undergoing resection for locally advanced GC.