Clinical Rewiew of Stomach Cancer in Young Patients

Ko, Jeong Hyun; Lee, Sung Do

Abstract

Several studies have demonstrated the poor prognosis for young patients with gastric cancer. However few reports exist about the dependence of the survival rate on curative resection and cancer stage. Hospital records of 107 young gastric cancer patients who underwent operations from 1980 to 1996 were reviewed, and the results were compared with those from 3176 cases involving whole age gastric cancer patients. There were no significant differences in operation method, tumor invasion, and tumor stage between both age groups. In whole age patients, males were predominant; however in young patients, females were predominant (p=0.005). In young patients, the tumors more frequently occurred in the upper 1/3 than in whole age patients(p<0.0001). A comparison of histologic types showed that poorly differentiated histologic types, such as signet ring cells and diffuse types, according to Lauren's classification, were more frequently observed in young patients (p<0.0001). The 5- year overall survival rate revealed a difference, but with borderline significance, between the young and the whole age patients (39.4% vs 48.6%, p=0.0505). However, patients who had undergone a curative resection showed no statistically significant difference(56.9% vs 63.9%; p=0.264). And patients with noncurative resection showed a statistically significant difference(0% vs 11.7%, p=0.034). The survival rate according to TNM stage revealed a statistically significant difference at stages I b and III b (Stage I b - 100% vs 84.5%, p=0.047; Stage III b - 8.8%, vs 28.0%, p=0.049). In conclusion, young patients with stomach cancer who underwent a curative resection showed a similar survival rate to that of whole age patients, and the largest survival rate was for cancer in a relatively early stage. Hence curative resection and early diagnosis are mandatory in young patients with stomach cancer.