Gastric Cancer in Young Patients Who Underwent Curative Resection

Abstract

Although several studies demonstrated the poor prognosis of young patients with gastric cancer, there were few reports about the survival of young patients who underwent radical surgery. We retrospectively reviewed the hospital records of 697 patients with curatively resected locally advanced gastric cancer to compare the pathologic findings and prognosis of young patients (aged < 40 years; 91 patients) with those of older (aged > or = 40 years; 606 patients) patients. There were no significant differences in location of tumors, Borrmann types, tumor invasion, and pathologic stage between both age groups. Despite the male predominance in older patients, the male-to-female ratio was nearly equal in young patients (p = 0.022). A significantly higher percentage of young patients showed poorly differentiated histology including signet ring cell and undifferentiated carcinoma than older patients (p < 0.0001). Adjuvant chemotherapy was more frequently performed in the young patients with a variety of different regimens (85.7 vs. 72.3%; p = 0.009). The 5-year overall survival rate revealed no statistically significant differences between the young and older patients (53.1 vs. 56.6%; p = 0.820). In conclusion, the young patients with curatively resected locally advanced gastric cancer showed similar survival compared to that of older patients.

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

“…Gross patterns, depressed lesions were found more common than polypoidal gross pattern in young patients in the present study similar to earlier reports (Choi et al, 1996;Nakamura et al, 1999;Yokota et al, 1999; found. Nakamura et al, reported that only 2 out of 60 patients with polypoid lesions whereas Choi et al, did not Nakamuara et al, 1999).…”

Early Onset Gastric Cancer No Longer Presents as an Advanced Disease with Ominous Prognosis

“…Several studies have shown that younger patients have higher frequencies of gastric cancers located in the body [14, 44, 51], while others have reported a higher frequency in the antrum [9, 15, 46, 47, 52]. In our study, a higher frequency of cases with cancer located in the antrum was observed in both groups of patients, for both main histological types (intestinal and diffuse carcinomas).…”

“…In patients between 30 and 45 years, this ratio was inverted (M/F 1.46:1) and became similar to that observed in patients older than 45 years (M/F 1.7:1). The reasons for the increasing frequency of males with increasing age in gastric cancer are currently unknown [14, 47]. One explanation might be the fact that male patients have more frequent and longer exposure to environmental carcinogens than females [39, 48].…”

“…In the past, some authors reported a significantly worse prognosis in younger than in older patients, mainly due to a high proportion of advanced stages, attributed to a delay in diagnosis and the aggressive biological behavior of gastric cancer in young adults [12, 16, 18, 30, 33]. However, recent reports show that the outcome of gastric cancer patients is related to the stage of disease at diagnosis, and that the prognosis of younger patients is comparable to that of older patients at similar stages [9,10,11, 14,19,20,21, 47]. Using the age of 45 years as a cutoff, two studies [7, 24] showed that age was an independent prognostic factor, in keeping with the findings of the present study (table 5).…”

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

“…These findings suggest that estrogen may play a role in the pathogenesis of GC. Other assumptions pertaining to female predominance in young patients include exposure to carcinogenic factors, which was more frequent and of longer duration in males than females [27]. Despite of this unique gender ratio, there are no known gender-related differences in GC patient prognosis [15,17].…”