Clinicopathological features of gastric cancer in young patients.
BACKGROUND
Early-onset gastric cancer is relatively rare. To evaluate the clinicopathological features and surgical outcome of young patients with gastric cancer, this retrospective comparative study was conducted.


METHODS
From 2000 to 2010, 4882 patients underwent surgery for gastric adenocarcinoma in our institution. A total of 136 patients under 40 years old were enrolled as the young group, and a total of 1435 patients aged between 60 and 69 were identified as the control group for this study. The patient's characteristics, pathological findings, surgical and clinical outcomes were reviewed, and the risk factors of recurrence were compared between the two groups.


RESULTS
Among the young group, patients had significantly fewer comorbidities and postoperative complications. The patient proportion having 7 or more lymph node metastases was higher in the young group (25 %) than in the control group (16 %). The presence of lymph node metastasis was identified as a strong risk factor for recurrence (odds ratio = 4.31) in the young group according to the results of the step-wise logistic regression analysis. Although the disease-specific survival at stage II was relatively better in the young group (p = 0.0439) than in the control group, there were no significant differences in overall survival for all stages.


CONCLUSIONS
Early-onset gastric cancer is likely to present lymph node metastases. The survival rate of gastric cancer in young patients was equivalent to that in patients in their 60s, which is the typical age at onset.
Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan.
Yukiko
Y
Takatsu
Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan. naoki.hiki@jfcr.or.jp.|Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan. naoki.hiki@jfcr.or.jp.
Naoki
N
Hiki
Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan.
Souya
S
Nunobe
Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan.
Manabu
M
Ohashi
Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan.
Michitaka
M
Honda
Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan.
Toshiharu
T
Yamaguchi
Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan.
Toshifusa
T
Nakajima
Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan.
Takeshi
T
Sano
D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D007564:Japan; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
Gastrectomy; Gastric cancer; Risk factor; Young patients