title: Clinicopathological features of gastric carcinoma in younger and middle-aged patients: a comparative study.
abstract: Gastric carcinoma is relatively rare in patients under the age of 40. This study was undertaken to clarify the clinicopathological characteristics and surgical outcomes of gastric carcinoma in younger patients compared with those of middle-aged patients. The surgical results from 131 younger patients (aged < or = 40 years) and 918 middle-aged patients (aged 55-65 years) were compared retrospectively. Female gender, undifferentiated tumor type and lymphatic invasion were significantly more common in the younger patients. Survival time did not differ between the two groups. The depth of tumor invasion was the only prognostic factor in younger patients, whereas macroscopic appearance, tumor diameter, depth of invasion, lymph node metastasis, and venous invasion were all significant prognostic factors in middle-aged patients. Peritoneal recurrence was significantly more common in younger patients. A family history of gastric adenocarcinoma was observed in 25.9% of younger patients, but this did not affect survival outcomes. As depth of invasion affects prognosis independently, and peritoneal metastasis is the predominant pattern of recurrence, it is essential to establish an optimal prophylactic treatment for peritoneal metastasis to improve surgical outcomes in younger patients with advanced gastric cancer.
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan. s0714@med.yokohama-cu.ac.jp
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Akiyama
authors.forename: Masato
authors.initials: M
authors.lastname: Nomura
authors.forename: Goro
authors.initials: G
authors.lastname: Matsuda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Hidetaka Andrew
authors.initials: HA
authors.lastname: Ono
authors.forename: Ryo
authors.initials: R
authors.lastname: Takagawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nagahori
authors.forename: Masazumi
authors.initials: M
authors.lastname: Takahashi
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kito
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate