title: Retrospective analysis of prognostic outcome of gastric cancer in young patients.
abstract: BACKGROUND
  It has been suggested that gastric cancer in young patients has a worse prognosis than in older patients, but this is controversial. This retrospective investigation was undertaken to understand the clinicopathological features and identify the prognostic factors of gastric cancer in young patients.
  
  
  METHODS
  Patients included in this study were those treated and followed up for gastric cancer from 1989 to 2005. Operative records, clinical, pathological, and follow-up data were reviewed. The critical age cut-off value for obtaining distinctive prognoses was 34 years.
  
  
  RESULTS
  Of 1730 gastric cancer patients whose records were reviewed, 27 were less than 34 years old (YGC group). The YGC group contained significantly higher percentages of females, stage IV, macroscopic type 4 tumors, poorly differentiated histology, peritoneal dissemination, and epigastric pain symptoms than the gastric cancer group aged 34 years or more (OGC group). Survival in the YGC group was significantly worse than in the OGC group (p = 0.0363). Ten-year survival was 68.5% in the YGC group and 81.8% in the OGC group. Survival in the YGC group was poorer for the stage IV patients, compared with OGC patients, especially for the stage IV patients with peritoneal dissemination and without liver metastases (H0P1 patients) (p = 0.049).
  
  
  CONCLUSIONS
  Age in gastric cancer affects the prognosis, which in gastric cancer patients less than 34 years old was significantly poorer than for older patients, because of the high incidence of stage IV cancer with peritoneal dissemination in gastric cancer patients less than 34 years old.
authors.affiliation: Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Rieko
authors.initials: R
authors.lastname: Nakamura
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Saikawa
authors.forename: Tsunehiro
authors.initials: T
authors.lastname: Takahashi
authors.forename: Hiroya
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Humiki
authors.initials: H
authors.lastname: Asanuma
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Yamada
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult