Even Young Patients with No Alarm Symptoms Should Undergo Endoscopy for Earlier Diagnosis of Gastric Cancer

Bołdys, H; Trněný, Marek; Wańczura, Piotr; Matusik, Paweł; Nowak, Adriana

doi:10.1055/s-2003-36414

Cited by 45 publications

(41 citation statements)

References 13 publications

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“…However, these screening criteria do not address populations younger than 40 years; thus, this subgroup of GC patients may be overlooked, leading to a potential delay in diagnosis and worse disease outcomes. Bołdys et al [34] suggested that in areas of relatively high prevalence of GC, dyspeptic patients younger than 45 years and without alarm symptoms should undergo upper gastrointestinal endoscopy in order to avoid any potential delay in GC diagnosis. However, beyond evaluation of symptomatic patients, there should be increased and focused investigations designed to determine an optimal age threshold for screening endoscopy in the asymptomatic normal population.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and outcomes for gastric cancer patients aged 18–30 years

et al. 2014

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Background There is little known about the clinicopathological features and the predictors of survival in extremely young adult patients aged 18-30 years. The aim of this study was to identify clinicopathological features and clinical outcomes for the overall population and for a resectable subgroup of gastric cancer patients aged 18-30 years.Methods From January 2004 to December 2010, 207 patients aged between 18 and 30 years old were diagnosed with gastric cancer and treated at the Asan Medical Center. Clinical findings, histopathological parameters and outcomes were reviewed retrospectively. Patients were further divided into 2 groups according to tumor resectability and then clinicopathological factors that affect tumor resectability and clinical outcomes were analyzed. Results Clinicopathological characteristics of study population showed a predominance of females, undifferentiated tumors, diffuse-type cancers, and advanced gastric cancer. The overall resectability rate was 70.0 % and the median follow-up period was significantly longer in the resectable tumor group (P \ 0.001). Significant prognostic predictors for overall survival in overall patients were higher CEA levels (P = 0.016), larger tumor size (P \ 0.001), unresectability (P = 0.006), and presence of lymphovascular invasion (P = 0.012) in a multivariate analysis. Significant prognostic factors for overall survival in patients with resectable disease included larger tumor size ([4 cm), lymphovascular invasion and higher CEA level in the multivariate analysis. Conclusions Gastric adenocarcinomas in young adult patients aged 18-30 years have unique clinicopathological features. Early detection in a resectable state and subsequent complete resection could increase survival period in young patients with gastric cancer.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and outcomes for gastric cancer patients aged 18–30 years

et al. 2014

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“…Presentation, both young and old patients have almost similar symptoms, but owing to its relatively uncommon presentation in young age group, the diagnosis may be delayed or less likely to be accurately made preoperatively (Medina-Franco et al, 2000). Epigastric pain is reported reports have indicated that the tendency to omit endoscopy in dyspeptic patients younger than 45 years might be leading to an increased rate of delayed GC diagnosis (Boldys et al, 2003). Boldys et al (2003) suggested that age and symptoms could not determine the need for endoscopy, at least in area of high prevalence of GC.…”

Section: Discussionmentioning

confidence: 99%

“…Epigastric pain is reported reports have indicated that the tendency to omit endoscopy in dyspeptic patients younger than 45 years might be leading to an increased rate of delayed GC diagnosis (Boldys et al, 2003). Boldys et al (2003) suggested that age and symptoms could not determine the need for endoscopy, at least in area of high prevalence of GC.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological and p53 Gene Alteration Comparison between Young and Older Patients with Gastric Cancer

Karim¹

2014

Asian Pacific Journal of Cancer Prevention

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“…There is a gradual increase in the risk of gastric and oesophageal cancer with age, but, unfortunately, a clear cut-off is difficult to define. Although, in the vast majority of the populations studied, almost 90% of patients with cancer are > 50 years, albeit the age distribution of upper gastro-intestinal cancer may vary; indeed, in Poland, Boldys [22] showed that, in a highrisk tertiary care population, as many as 24% of patients with gastric cancer were < 45 years.…”

Section: Introductionmentioning

confidence: 99%

Role of symptoms in diagnosis and outcome of gastric cancer

Maconi¹,

Manes²,

Porro³

2008

WJG

170

105

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Gastric cancer is one of the most common cancers and the second most common cause of cancer deaths w o r l d w i d e . A p a r t f r o m J a p a n , w h e r e s c r e e n i n g programmes have resulted in early diagnosis in asymptomatic patients, in most countries the diagnosis of gastric cancers is invariably made on account on dyspeptic and alarm symptoms, which may also be of prognostic significance when reported by the patient at diagnosis. However, their use as selection criteria for endoscopy seems to be inconsistent since alarm symptoms are not sufficiently sensitive to detect malignancies. In fact, the overall prevalence of these symptoms in dyspeptic patients is high, while the prevalence of gastro-intestinal cancer is very low. Moreover, symptoms of early stage cancer may be indistinguishable from those of benign dyspepsia, while the presence of alarm symptoms may imply an advanced and often inoperable disease. The features of dyspeptic and alarm symptoms may reflect the pathology of the tumour and be of prognostic value in suggesting site, stage and aggressiveness of cancer. Alarm symptoms in gastric cancer are independently related to survival and an increased number, as well as specific alarm symptoms, are closely correlated to the risk of death. Dysphagia, weight loss and a palpable abdominal mass appear to be major independent prognostic factors in gastric cancer, while gastro-intestinal bleeding, vomiting and also duration of symptoms, do not seem to have a relevant prognostic impact on survival in gastric cancer.

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Even Young Patients with No Alarm Symptoms Should Undergo Endoscopy for Earlier Diagnosis of Gastric Cancer

Cited by 45 publications

References 13 publications

Clinical characteristics and outcomes for gastric cancer patients aged 18–30 years

Clinical characteristics and outcomes for gastric cancer patients aged 18–30 years

Clinicopathological and p53 Gene Alteration Comparison between Young and Older Patients with Gastric Cancer

Role of symptoms in diagnosis and outcome of gastric cancer

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