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Annals of Surgical Oncology, Vol 7, Issue 5 346-351, Copyright © 2000 by Society of Surgical Oncology

ARTICLES

Gastric cancer in young patients: demographic, clinicopathological, and prognostic factors in 92 patients

J. B. Koea, M. S. Karpeh and M. F. Brennan
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.

BACKGROUND: This investigation was undertaken to define the demographic, clinicopathological, and prognostic factors relevant to young patients with gastric adenocarcinoma. METHODS: A prospective database of all patients with gastric cancer who presented to Memorial Sloan-Kettering Cancer Center was started in 1985. Clinical, pathological, and operative records and follow-up data on 92 patients, 40 years of age or younger, with a primary diagnosis of gastric cancer were reviewed. RESULTS: The mean patient age was 35 +/- 4.9 years (range, 17-40 years), and 52 were male. The male-to-female ratio of patients younger than 30 was 0.85/1; whereas in those older than 30, the ratio was 1.45/1. Sixty-six percent of the patients were white, 15% Asian, 11% Hispanic, and 8% were black American. Nineteen percent of patients reported a family history of gastric cancer. Sixty-six patients (71%) presented with stage III or IV disease, whereas 13 patients, each, presented with stage I or II disease. Poorly differentiated lesions were present in 71%. Resection with curative intent was undertaken in 47 patients, and resection with palliative intent was performed in 24 patients. Tumor site (proximal vs. distal vs. linitus plastica), advanced T stage, and the presence of nodal disease were significant predictors of disease-free survival on both univariate and multivariate analyses. The mean survival time and disease-specific 5-year survival rates for individual Union International Contre le Cancer tumor stages were similar to those observed in older populations of patients with gastric cancer; and eight patients, who presented with early (T1/T2) node-negative tumors, are alive and well a minimum of 60 months after resection. CONCLUSIONS: The high frequency of a positive family history in young patients suggests an opportunity to identify a high-risk population for screening.


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J. F. Lai, S. Kim, C. Li, S. J. Oh, W. J. Hyung, W. H. Choi, S. H. Choi, L. B. Wang, and S. H. Noh
Clinicopathologic Characteristics and Prognosis for Young Gastric Adenocarcinoma Patients after Curative Resection
Ann. Surg. Oncol., May 1, 2008; 15(5): 1464 - 1469.
[Abstract] [Full Text] [PDF]


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