title: Gastric adenocarcinoma under the age of 40; more metastatic, less differentiated.
abstract: OBJECTIVE
  Gastric carcinoma is relatively rare under the age of 40 years, and the mean age at presentation is 65 years. Histologically, adenocarcinoma prevails. Previous studies state that gastric adenocarcinoma under 40 is more aggressive. The present retrospective study was undertaken to clarify the clinicopathological characteristics of gastric adenocarcinoma in patients under 40 and to compare their clinical features with the patients over 40 years of age.
  
  
  METHODS
  All of the patients with histologically diagnosed gastric adenocarcinoma who had applied to our department from March 2001 to September 2009 were retrospectively evaluated. Patients were stratified according to their age at diagnosis (≤ 40 years; group 1, and > 40 years; group 2). Their clinical, laboratory, and pathological characteristics were analyzed.
  
  
  RESULTS
  251 patients were studied. Sixty-eight percent of those under 40 and 46% over 40 had poorly differentiated histology (p= 0.036). Fifteen (60%) patients under 40 and 73 (32.3%) over 40 had metastatic diseases (p=0.007).
  
  
  CONCLUSIONS
  Younger patients with gastric adenocarcinoma have less differentiated, more advanced and metastatic disease. Patients' complaints, tumor localization, metastatic sites and smoking did not differ significantly between the groups. Controversy for survival parameters still exists.
authors.affiliation: Department of Medical Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey. metin1721978@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Isik
authors.forename: S
authors.initials: S
authors.lastname: Caner
authors.forename: M
authors.initials: M
authors.lastname: Metin Seker
authors.forename: B
authors.initials: B
authors.lastname: Civelek
authors.forename: H
authors.initials: H
authors.lastname: Odabas
authors.forename: N
authors.initials: N
authors.lastname: Ozdemir
authors.forename: D
authors.initials: D
authors.lastname: Uncu
authors.forename: N
authors.initials: N
authors.lastname: Zengin
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002454:Cell Differentiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000473:pathology*