Gastric cancer in young patients: demographic, clinicopathological, and prognostic factors in 92 patients.
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.
Koea
J B
JB
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Karpeh
M S
MS
Brennan
M F
MF
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D016208:Databases, Factual; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis