title: Clinicopathologic characteristics and prognostic of gastric cancer in young patients.
abstract: OBJECTIVE
  Gastric cancer (GC) in young patients is thought to exhibit a worse prognosis due to specific clinicopathologic characteristics and delayed diagnosis; however, the data are controversial. This study aimed to analyse the clinicopathologic characteristics and prognostic factors of GC in young patients and to determine whether GC is a different clinical entity in younger vs. older patients.
  
  
  METHODS
  Clinical data of 3930 gastric cancer patients who underwent radical gastrectomy were retrospectively analysed and divided into two age groups. The younger group consisted of 342 cases of patients aged 40 years or younger at the time of surgery, and the older group included 3588 cases of patients older than 40 years. Clinicopathologic characteristics were compared using Pearson's χ(2) or Fisher's exact tests, and survival curves were constructed using the Kaplan-Meier method.
  
  
  RESULTS
  Clinicopathologic characteristics of the younger group exhibited a predominance of females (p < 0.001), diffuse stomach lesions (p = 0.014), signet-ring cell type (p < 0.001), poorly differentiated histological tumours (p < 0.001), Borrmann type IV (p < 0.001), mixed Lauren's classification types (p = 0.004), and recurrence rate in the gastric remnant (p < 0.001). The overall 5-year survival rates in the younger group and older group were 60.8% and 53.7%, respectively (p = 0.017). When stratified by TNM stage, the younger group exhibited enhanced 5-year survival at stage IV compared with the older group (26.9% VS. 10.3%, p = 0.003).
  
  
  CONCLUSIONS
  Although younger patients with GC exhibit more aggressive cancer patterns and higher recurrence rate in the gastric remnant, the overall 5-year survival rate may be better than older patients.
authors.affiliation: a Department of General Surgery , Changhai Hospital, Second Military Medical University , Shanghai , China.
authors.forename: Zhongjun
authors.initials: Z
authors.lastname: Wang
authors.affiliation: a Department of General Surgery , Changhai Hospital, Second Military Medical University , Shanghai , China.
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.affiliation: a Department of General Surgery , Changhai Hospital, Second Military Medical University , Shanghai , China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Shi
authors.affiliation: a Department of General Surgery , Changhai Hospital, Second Military Medical University , Shanghai , China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Shen
authors.affiliation: a Department of General Surgery , Changhai Hospital, Second Military Medical University , Shanghai , China.
authors.forename: Tianghang
authors.initials: T
authors.lastname: Luo
authors.affiliation: a Department of General Surgery , Changhai Hospital, Second Military Medical University , Shanghai , China.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Bi
authors.affiliation: a Department of General Surgery , Changhai Hospital, Second Military Medical University , Shanghai , China.
authors.forename: Mingming
authors.initials: M
authors.lastname: Nie
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002681:China; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis
keywords: Clinicopathologic characteristics; gastric cancer; old patients; prognostic; young patients