Decisions for extent of gastric surgery in gastric cancer patients: younger patients require more attention than the elderly.
OBJECTIVE
There is a prevailing belief that young patients with gastric adenocarcinomas have a more aggressive disease.


METHODS
We reviewed the prospectively collected database of 753 gastric adenocarcinomas patients who had undergone curative gastrectomy. Clinicopathological factors and the survival rates for each pathological TNM stage were compared between patients younger than 40 years of age and the others.


RESULTS
Fifty-four (9.8%) patients were younger than 40 years of age. The overall accuracy of the intra-operative stage was 62.5%; 54.0% in the young patients and 63.5% in older patients (P = 0.006). Intraoperative under-staging was more commonly seen in the younger patients when compared to the older patients. These trends were more prominent in patients with surgical stage I disease. Age proved to be an independent risk factor influencing the accuracy of intraoperative staging using a logistic regression analysis. There was no difference in overall 3-year survival rate between the two age groups for each pathological TNM stage.


CONCLUSIONS
The present study showed that intra-operative under-staging was more common in young patients with gastric cancer, especially with stage I disease. This finding raises the concern for inaccurate diagnosis and surgical under treatment in younger patients with stage I gastric cancer.
Lee
Jun Ho
JH
Center for Gastric Cancer, National Cancer Center, Ilsandong-gu, Goyang-si, Gyeonggi-do, Korea.
Ryu
Keun Won
KW
Lee
Jong Seok
JS
Lee
Jong Ryeol
JR
Kim
Chan Gyoo
CG
Choi
Il Ju
IJ
Park
Sook Ryun
SR
Kook
Myeong-Cherl
MC
Kim
Young-Woo
YW
Bae
Jae-Moon
JM
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome