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Adjuvant chemotherapy such as S-I is thought to prolong the life expectancy of patients with gastric cancer. The number of older patients with gastric cancer has recently been increasing. Here we examined the prognosis of older patients with stage II or III gastric cancer. Methods: The study cohort comprises 658 patients with stage II or III gastric cancer who underwent curative surgery from 1994 to 2014 in our institution. From 1994 to 2003 was considered the early phase, whereas from 2004 to 2014 was considered the late phase. The patients were classifi ed by age into under 65 years (Non-Elderly [NE]); 65-74 years (Early Elderly [EE]); and over 74 years (Late Elderly [LE] groups. Results: Signifi cantly more patients in the late phase than the early phase received S-1. Signifi cantly fewer LE patients than NE or EE patients underwent adjuvant chemotherapy. Signifi cantly more deaths were caused by a comorbidity in patients with stage II disease in the LE group than in the other groups. Overall Survival (OS) of patients with stage II or III disease was signifi cantly lower in the LE group than in the other groups. Disease-Specifi c Survival (DSS) of patients with stage III disease was signifi cantly higher in the NE group than in the other groups. Both OS and DSS were signifi cantly higher in patients with stage III disease in the late phase than in the early phase. Both OS and DSS of patients with stage III disease were signifi cantly better in the adjuvant than the non-adjuvant group. Conclusion: Adjuvant chemotherapy such as S-I is thought to prolong the life expectancy of patients with gastric cancer. However, administration of adjuvant chemotherapy to LE patients with stage II disease must be carefully considered because of the high comorbidityrelated mortality.

Prognosis of Older Patients with Stage II and III Gastric Cancer