# Age-dependent diminution of female prognostic advantage in gastrointestinal stromal tumors: a retrospective cohort analysis

## TL;DR

Younger female patients with gastrointestinal stromal tumors have better survival outcomes than males, but this advantage decreases with age.

## Contribution

This study identifies a sex-based survival advantage in younger female GIST patients that diminishes with age.

## Key findings

- Females had a significantly lower hazard ratio for disease-specific survival compared to males (HR = 1.40).
- The female prognostic advantage was most pronounced in patients aged ≤50 years.
- The interaction between age and sex significantly influenced disease-specific survival outcomes.

## Abstract

Sex and age are significant factors influencing the prognosis of various types of cancer. However, the impact of sex and age on the prognosis of gastrointestinal stromal tumors (GISTs) remains unclear. Investigating the interaction between sex and age may facilitate a more precise assessment of the prognosis of GISTs.

A retrospective analysis was conducted on a cohort of 5318 patients with GISTs, utilizing the Cox regression model to analyze the disparities in disease-specific survival (DSS) across sex. Subsequently, the cohort after propensity score matching was employed to investigate the prognostic differences attributable to age variations, and restricted cubic spline analysis was utilized to assess the prognostic disparities associated with different sexes and ages in GIST.

This investigation demonstrated substantial sex-based disparities in the clinical characteristics of GIST. With respect to prognosis, males exhibited a significantly elevated hazard ratio (HR) for DSS in comparison to females (HR = 1.40, p<0.001), which persisted following multivariate (HR = 1.38, p=0.006) and propensity score matching analyses (HR = 1.36, p=0.014). Moreover, a significant interaction between age and sex was observed in predicting DSS, notably indicating that younger female subjects (≤50 years) demonstrated a more favorable prognosis relative to their male counterparts.

Female patients with GIST exhibit a more favorable prognosis than males, with this advantage decreasing with advancing age.