Incidence and long-term outcome of young patients with gastric carcinoma according to sex: does hormonal status affect prognosis?
BACKGROUND
We investigated the clinicopathological features and evaluated the prognostic impact of age and sex on patients with gastric cancer.


METHODS
Retrospective study from 1993 to 2000.


METHODS
Korea University Medical Center.


METHODS
A total of 1299 patients with gastric cancer were divided into young (n = 175 [13.5%]) and older (n = 1124 [86.5%]) groups with an age cutoff of 40 years.


METHODS
Clinicopathological characteristics were investigated and survival analysis was performed according to sex for each age group.


RESULTS
Tumor differentiation was significantly different between the 2 age groups. Among male patients, the young group had more undifferentiated tumors than the older group (P < .001) but, in female patients, both differentiation (P < .001) and operative methods (P = .008) were significantly different between the young and older groups. In male patients, the 10-year survival rate of the young group was higher (62.5%) than that of the older group (44.6%) (P = .03). Although it was not statistically significant, the survival rate of the older female group was higher than that of the young group (56.2% vs 51.9%). On multivariate analysis, tumor stage (P < .001) and sex (P = .042) were proved to be independent prognostic factors.


CONCLUSIONS
Only tumor differentiation was an important difference between the 2 age groups, and prognosis was not affected by age. However, when sex was added to age as a factor, the older male and young female groups had an unfavorable prognosis. Therefore, we propose that sex hormones such as estrogens contribute to the survival differences, and further studies are needed to confirm this possibility.
Kim
Jong-Han
JH
Department of Surgery, Korea University College of Medicine, Korea University Anam Hospital, Anam-dong 5-ga Seongbuk-gu, Seoul 136-705, Korea.
Boo
Yoon-Jung
YJ
Park
Joong-Min
JM
Park
Sung-Soo
SS
Kim
Seung-Joo
SJ
Kim
Chong-Suk
CS
Mok
Young-Jae
YJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D002277:Carcinoma / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000502:physiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome
D012739:Gonadal Steroid Hormones