Clinicopathologic characteristics and prognosis for young gastric adenocarcinoma patients after curative resection.
BACKGROUND
Conflicting results from previous studies on gastric adenocarcinoma (GC) in young patients have led to controversy surrounding the prognosis for young GC patients.


METHODS
The authors studied 6954 patients with GC who received curative resections. They were classified into three groups: those aged 40 years or less ("young," 12.7%); those aged 41-65 years ("middle-aged," 66.7%); and those aged more than 65 years ("elderly," 20.6%). Clinicopathologic characteristics and overall survival rates were analyzed.


RESULTS
Young patients were predominately female and had tumors that were histologically undifferentiated. However, in regard to T4 invasion, N3 lymph node metastasis, and TNM stage IV, the characteristics of the tumors of young patients were similar to those of middle-aged and elderly patients. Overall survival rate was significantly better in young patients than middle-aged patients (P = .018) and elderly patients (P < .001). Stratified by TNM stage, young patients showed better overall survival at stage I than middle-aged patients, and at stages I, II, and IIIa than elderly patients. Multivariate analysis indicated that age was an independent prognostic factor (as well as gender, operation type, depth of invasion, and lymph node status).


CONCLUSIONS
The predominance of female cases and tumors that were histologically undifferentiated were distinctive characteristics in young patients. Young patients could gain a survival benefit after curative resection with stage I disease.
Lai
Ji Fu
JF
Department of Surgery, Yonsei University College of Medicine, Seoul 120-752, Korea.
Kim
Sungsoo
S
Li
Chen
C
Oh
Sung Jin
SJ
Hyung
Woo Jin
WJ
Choi
Won Hyuk
WH
Choi
Seung Ho
SH
Wang
Lin Bo
LB
Noh
Sung Hoon
SH
D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002454:Cell Differentiation; D005260:Female; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate