A Clinicopathological Analysis of Gastric Cancer in Young Patients

Jun, Kyong Hwa; Im, Myoung Goo; Won, Yong Sung; Cho, Hyun Min; Heo, Youn Jung; Chin, Hyung Min; Kim, Jun Gi; Park, Woo Bae; Chun, Chung Soo

Abstract

PURPOSE
Gastric cancer is believed to be a disease of the elderly, and rarely occurs in young patients. The aim of this study was to analyze the clinicopathological and prognostic factors related to young gastric cancer patients. METHODS: A total of 877 patients with gastric cancer from 1995 to 2004 in a secondary referral center in Suwon City were enrolled in this study. The clinicopathological features of the young (aged<40 years) gastric cancer patients were compared with those of the older (aged > or =40 years) patients. The overall survival was the main outcome measure. The survival curves were constructed using the Kaplan-Meier method, Univariate analysis was performed using the log-rank test, and multivariate analysis was performed using with Cox regression. A P value<0.05 was considered significant. RESULTS: Of the 877 patients, 65(7.4%) were in the young age group. The mean age of this group was 34.9 years (range, 19~39 years). The male-to-female ratio of the patients younger than 40 was 1.24/1; whereas the ratio was 2.07/1 in those older than 40. 7.7 percent of the patients had a family history of gastric cancer. A significantly higher percentage of young patients had a poorly differentiated histology than the older patients (P=0.0001). Twenty-three patients (38.9%) were stage III or IV disease, whereas 36 patients (61.0%) presented with stage I or II disease. A resection with a curative intent was undertaken in 53 patients (81.5%), and a resection with a palliative intent was performed in 12 patients (18.4%). With a mean follow-up of 39 months, the disease-specific 5-year survival rates were similar to those observed in the older group of patients. The variables with a significant impact on survival were a curative resection, a lymph node metastasis, lymphatic invasion, peritoneal metastasis, and adjuvant chemotherapy. CONCLUSION: There were no significant differences in the clinicopathological characteristics and clinical outcome of a gastric adenocarcinoma between the younger and older patients. The important prognostic factors were curability, lymph node metastasis, lymphatic invasion, peritoneal metastasis, and adjuvant chemotherapy.