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Decisions for extent of gastric surgery in gastric cancer patients: Younger patients require more attention than the elderly
Author(s) -
Lee Jun Ho,
Ryu Keun Won,
Lee Jong Seok,
Lee Jong Ryeol,
Kim Chan Gyoo,
Choi Il Ju,
Park Sook Ryun,
Kook MyeongCherl,
Kim YoungWoo,
Bae JaeMoon
Publication year - 2006
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20707
Subject(s) - medicine , pathological , stage (stratigraphy) , gastrectomy , cancer , disease , logistic regression , surgery , pathological staging , young adult , paleontology , biology
Abstract Background and Objectives There is a prevailing belief that young patients with gastric adenocarcinomas have a more aggressive disease. Methods We reviewed the prospectively collected database of 753 gastric adenocarcinomas patients who had undergone curative gastrectomy. Clinicopathological factors and the survival rates for each pathological TNM stage were compared between patients younger than 40 years of age and the others. Results Fifty‐four (9.8%) patients were younger than 40 years of age. The overall accuracy of the intra‐operative stage was 62.5%; 54.0% in the young patients and 63.5% in older patients ( P = 0.006). Intraoperative under‐staging was more commonly seen in the younger patients when compared to the older patients. These trends were more prominent in patients with surgical stage I disease. Age proved to be an independent risk factor influencing the accuracy of intraoperative staging using a logistic regression analysis. There was no difference in overall 3‐year survival rate between the two age groups for each pathological TNM stage. Conclusions The present study showed that intra‐operative under‐staging was more common in young patients with gastric cancer, especially with stage I disease. This finding raises the concern for inaccurate diagnosis and surgical under treatment in younger patients with stage I gastric cancer. J. Surg. Oncol. 2007; 95: 485–490. © 2006 Wiley‐Liss, Inc.