title: Early onset gastric cancer no longer presents as an advanced disease with ominous prognosis.
abstract: BACKGROUND
  This study aimed to characterize the clinicopathological features and prognosis of early onset gastric carcinomas (EOGCs) in a sample of young Portuguese adults.
  
  
  METHODS
  A subset of 415 patients submitted to gastric resection was divided into 2 groups: A--patients aged 45 years or less (n = 108), and B--patients older than 45 years (n = 307). The groups were compared for several clinicopathological features and the survival of the patients was analyzed by uni- and multivariate analysis.
  
  
  RESULTS
  The surgical resection rate was higher in young patients, in whom tumors more frequently displayed an ulcerative shape (p < 0.001) and diffuse/isolated cell-type histology (p < 0.001). In the elderly, the rate of vascular invasion was significantly higher (p = 0.002). Overall, the survival of young patients was higher than in the elderly (p < 0.001). Survival curves were higher in young patients, except for pT4 and pM1 cases. In the multivariate survival analysis, age (p < 0.001), depth of tumor invasion (p < 0.001), nodal status (p < 0.001), vascular invasion (p = 0.011) and distant metastases (p = 0.007) emerged as independent prognostic factors for gastric carcinoma.
  
  
  CONCLUSIONS
  Young gastric cancer patients no longer present with more advanced disease than the elderly and, overall, survival is better in young patients.
authors.affiliation: Department of General Surgery, Hospital S. João, Porto, Portugal. herculano.moreira@live.com.pt
authors.forename: H
authors.initials: H
authors.lastname: Moreira
authors.forename: J
authors.initials: J
authors.lastname: Pinto-de-Sousa
authors.forename: F
authors.initials: F
authors.lastname: Carneiro
authors.forename: M
authors.initials: M
authors.lastname: Cardoso de Oliveira
authors.forename: A
authors.initials: A
authors.lastname: Pimenta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011174:Portugal / Q000453:epidemiology; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult