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Gastric cancer in the young: An advanced disease with poor prognostic features
Author(s) -
Rona Kais A.,
Schwameis Katrin,
Zehetner Joerg,
Samakar Kamran,
Green Kyle,
Samaan Jamil,
Sandhu Kulmeet,
Bildzukewicz Nikolai,
Katkhouda Namir,
Lipham John C.
Publication year - 2017
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.24533
Subject(s) - medicine , gastroenterology , adenocarcinoma , cancer , stage (stratigraphy) , incidence (geometry) , signet ring cell carcinoma , carcinoma , stomach , disease , survival rate , survival analysis , oncology , surgery , paleontology , physics , optics , biology
BACKGROUND AND OBJECTIVES Gastric cancer in young patients is rare. We analyzed the clinicopathological features and prognosis of early‐onset gastric carcinoma. METHODS We retrospectively reviewed patients with gastric adenocarcinoma aged ≤45 years and >45 years at our institution over a 17‐year period. Clinicopathological features were compared and survival analysis was performed using Kaplan‐Meier curves. RESULTS A total of 121 patients with gastric carcinoma aged ≤45 years were identified. The young group (YG) had a higher incidence of stage III/IV disease (86.8% vs. 57.9%, P < 0.001), poorly‐differentiated carcinoma (95.9% vs. 74.4%, P < 0.001), and signet‐cell type tumor (88.4% vs. 32.2%, P < 0.001) relative to the older group (OG). The majority of tumors were in the middle third of the stomach in both groups ( P = 0.108). Three‐year survival in the YG was 87.1%, 32.2%, and 6.9% in stage I/II, III, and IV disease, respectively. Surgical intervention in young patients with advanced carcinoma was not associated with improved survival. Although median survival was shorter in the YG compared to the OG (11.7 vs. 41.0 months, P < 0.001), stage‐specific survival was similar. CONCLUSION Early‐onset gastric cancer demonstrates advanced stage of disease, and a high incidence of poorly‐differentiated and signet‐cell type carcinoma. Overall survival is poor with no added benefit to surgical intervention in advanced disease.