Gastric Cancer in Young Patients: Demographic, Clinicopathological, and Prognostic Factors in 92 Patients

Ann Surg Oncol. 2000 Jun;7(5):346-51. doi: 10.1007/s10434-000-0346-9.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery
  • Adolescent
  • Adult
  • Age of Onset
  • Databases, Factual
  • Demography
  • Female
  • Humans
  • Male
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery
  • Survival Analysis