Clinicopathological Features of Gastric Carcinoma in Younger and Middle-Aged Patients: A Comparative Study

Kunisaki, Chikara; Akiyama, Hirotoshi; Nomura, Masato; Matsuda, Goro; Otsuka, Yuichi; Ono, Hideki; Takagawa, Ryo; Nagahori, Yutaka; Takahashi, Mutsuo; Kito, Fumihiko; Shimada, Hiroshi

doi:10.1016/j.gassur.2006.03.001

Cited by 35 publications

(40 citation statements)

References 23 publications

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“…(Table 1) Gender Data originating from both endemic and non-endemic areas show a male predominance in elderly gastric cancer patients but in young patients (<40 years old), the gender ratio has constantly been reported to be approximately 1:1 [2] with a significant number of studies reporting a female predominance [2][3]. This sexual imbalance may reflect a more frequent and prolonged exposure of male elderly M A N U S C R I P T…”

Section: A Clinicopathological Characteristics Of Gastric Cancer In mentioning

confidence: 99%

“…Only few studies have addressed the absence of positive family history in elderly gastric cancer patients [2] as compared to patients aged 45 years or less [3,10]. In Western countries, a hereditary type of diffuse, poorly-differentiated, infiltrative adenocarcinoma has been described in young patients.…”

Section: Family Historymentioning

confidence: 99%

“…It is generated by a germline mutation of the CDH1 gene, which encodes the adhesion molecule E-cadherin, inherited by the autosomal dominant mode [11,12]. Still, most investigators believe that gastric cancer genetic predisposition observed in patients under the age of 40 involves multiple genes and environmental factors [3,13].…”

Section: Family Historymentioning

confidence: 99%

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Gastric cancer in the elderly: An overview

Saif

Makrilia

Zalonis

et al. 2010

European Journal of Surgical Oncology (EJSO)

138

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Aims: Gastric cancer in the elderly represents a distinct entity with specific clinicopathological characteristics and the majority of affected patients belong to this age group. Subtotal or total gastrectomy with radical lymph node dissection, adjuvant chemo-radiotherapy or perioperative chemotherapy represent the only potentially curative treatment options and seem to be performed with acceptable morbidity and mortality rates in selected elderly patients. Published research is very limited due to the strict selection and under-representation of elderly patients in clinical trials. A review of current recommendations and practice was performed.Methods: A comprehensive literature review was performed searching Medline for articles published since 1974, using "gastric cancer", "elderly" and "treatment" as key words.Observations: The data suggest that elderly patients that fulfill the inclusion criteria of clinical trials experience the same advantages and toxicities from chemotherapy as younger patients. Fit elderly patients with operable gastric cancer should be canndidates for the standard surgical resection provided that pre-operative comorbidities are taken into account. Peri-operative chemotherapy or post-operative chemoradiotherapy should be added in case of locally advanced disease. Palliative systemic chemotherapy seems to prolong survival in recurrent and metastatic disease.Conclusions: Chronological age alone is not sufficient reason to withhold curative or palliative treatment from an elderly gastric cancer patient. Performance status does not suffice in order to estimate the general condition of elderly patients and cofactors regarding their functional, social and mental status have to be considered.Word count (abstract): 234

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Section: A Clinicopathological Characteristics Of Gastric Cancer In mentioning

confidence: 99%

Section: Family Historymentioning

confidence: 99%

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Gastric cancer in the elderly: An overview

Saif

Makrilia

Zalonis

et al. 2010

European Journal of Surgical Oncology (EJSO)

138

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“…One factor that has been cited as an indicator of poor prognosis of gastric cancer is early onset, i.e., that occurring in patients who are comparatively young [1][2][3][4]. Gastric cancer usually occurs in individuals aged 50-70 years [2,5,6] and is rare in the young [7][8][9]. Factors that contribute to the poor prognosis of gastric cancer in the young include delayed detection, resulting in an advanced stage at presentation, diffuse infiltration of the tumor and a poorly differentiated histology [1,4,10].…”

Section: Introductionmentioning

confidence: 99%

“…Factors that contribute to the poor prognosis of gastric cancer in the young include delayed detection, resulting in an advanced stage at presentation, diffuse infiltration of the tumor and a poorly differentiated histology [1,4,10]. On the other hand, recent studies have indicated that prognosis in young patients is equivalent to [7,11,12] or better than that in middle-aged patients with cancers at the same stage [8,9,13,14]. Thus, the concept of gastric cancer having a poorer prognosis in relatively young patients remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological features of gastric cancer in young patients

et al. 2015

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Background Early-onset gastric cancer is relatively rare. To evaluate the clinicopathological features and surgical outcome of young patients with gastric cancer, this retrospective comparative study was conducted. Methods From 2000 to 2010, 4882 patients underwent surgery for gastric adenocarcinoma in our institution. A total of 136 patients under 40 years old were enrolled as the young group, and a total of 1435 patients aged between 60 and 69 were identified as the control group for this study. The patient's characteristics, pathological findings, surgical and clinical outcomes were reviewed, and the risk factors of recurrence were compared between the two groups. Results Among the young group, patients had significantly fewer comorbidities and postoperative complications. The patient proportion having 7 or more lymph node metastases was higher in the young group (25 %) than in the control group (16 %). The presence of lymph node metastasis was identified as a strong risk factor for recurrence (odds ratio = 4.31) in the young group according to the results of the step-wise logistic regression analysis. Although the disease-specific survival at stage II was relatively better in the young group (p = 0.0439) than in the control group, there were no significant differences in overall survival for all stages. Conclusion Early-onset gastric cancer is likely to present lymph node metastases. The survival rate of gastric cancer in young patients was equivalent to that in patients in their 60s, which is the typical age at onset.

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Significant regional variation in adequacy of lymph node assessment and survival in gastric cancer

Coburn

Swallow

Kiss

et al. 2006

Cancer

165

152

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BACKGROUNDLymph node (LN) status is a major determinant of prognosis and treatment of gastric adenocarcinoma. The 1997 American Joint Commission on Cancer/Union Internationale Contre le Cancer guidelines were revised, requiring examination of ≥15 LN for staging.METHODSWe investigated compliance with these guidelines and the correlation with overall survival (OS) by analyzing 10,807 resected gastric cancers in the Surveillance, Epidemiology and End Results (SEER) database, 1988–2002. Kaplan–Meier survival curves were constructed; survival was compared by using Cox proportional hazards.RESULTSOverall, 29% of cases had ≥15 LN examined. After 1997, the median number of LN assessed increased from 9 to 10 (P < .0001). Factors predictive of adequate LN assessment (ALNA) were higher stage, worse grade, age <74 years, later year of diagnosis, nonwhite race, more extensive surgery, female sex, and SEER region. Differences in the rate of ALNA between regions were noted, ranging from 19.7–53% (P < .0001). Of T1N0 patients, 19% had ALNA. Improved OS was predicted by earlier stage, lower grade, marital status, Asian race, younger age, T‐stage, female sex, SEER region, and ALNA. Median OS was highest in the region with the best ALNA rate and worst in the region with the lowest (33 mos vs. 17 mos, P < .0001). Inadequate LN assessment led to poorer survival at every stage (P < .001).CONCLUSIONThe overwhelming majority of patients have an inadequate LN assessment. ALNA was associated with improved OS, with significant variation across regions. Understaging due to inadequate LN assessment may affect eligibility for adjuvant therapy. Education is required to improve LN retrieval. Cancer 2006. © 2006 American Cancer Society.

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Clinicopathological Features of Gastric Carcinoma in Younger and Middle-Aged Patients: A Comparative Study

Cited by 35 publications

References 23 publications

Gastric cancer in the elderly: An overview

Gastric cancer in the elderly: An overview

Clinicopathological features of gastric cancer in young patients

Significant regional variation in adequacy of lymph node assessment and survival in gastric cancer

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