title: Gastric cancer in the young: An advanced disease with poor prognostic features.
abstract: OBJECTIVE
  Gastric cancer in young patients is rare. We analyzed the clinicopathological features and prognosis of early-onset gastric carcinoma.
  
  
  METHODS
  We retrospectively reviewed patients with gastric adenocarcinoma aged ≤45 years and >45 years at our institution over a 17-year period. Clinicopathological features were compared and survival analysis was performed using Kaplan-Meier curves.
  
  
  RESULTS
  A total of 121 patients with gastric carcinoma aged ≤45 years were identified. The young group (YG) had a higher incidence of stage III/IV disease (86.8% vs. 57.9%, P < 0.001), poorly-differentiated carcinoma (95.9% vs. 74.4%, P < 0.001), and signet-cell type tumor (88.4% vs. 32.2%, P < 0.001) relative to the older group (OG). The majority of tumors were in the middle third of the stomach in both groups (P = 0.108). Three-year survival in the YG was 87.1%, 32.2%, and 6.9% in stage I/II, III, and IV disease, respectively. Surgical intervention in young patients with advanced carcinoma was not associated with improved survival. Although median survival was shorter in the YG compared to the OG (11.7 vs. 41.0 months, P < 0.001), stage-specific survival was similar.
  
  
  CONCLUSIONS
  Early-onset gastric cancer demonstrates advanced stage of disease, and a high incidence of poorly-differentiated and signet-cell type carcinoma. Overall survival is poor with no added benefit to surgical intervention in advanced disease.
authors.affiliation: Keck Hospital of USC (University of Southern California), University of Southern California Medical Center, Los Angeles, California.
authors.forename: Kais A
authors.initials: KA
authors.lastname: Rona
authors.affiliation: Keck Hospital of USC (University of Southern California), University of Southern California Medical Center, Los Angeles, California.
authors.forename: Katrin
authors.initials: K
authors.lastname: Schwameis
authors.affiliation: Keck Hospital of USC (University of Southern California), University of Southern California Medical Center, Los Angeles, California.
authors.forename: Joerg
authors.initials: J
authors.lastname: Zehetner
authors.affiliation: Keck Hospital of USC (University of Southern California), University of Southern California Medical Center, Los Angeles, California.
authors.forename: Kamran
authors.initials: K
authors.lastname: Samakar
authors.affiliation: Keck Hospital of USC (University of Southern California), University of Southern California Medical Center, Los Angeles, California.
authors.forename: Kyle
authors.initials: K
authors.lastname: Green
authors.affiliation: Keck Hospital of USC (University of Southern California), University of Southern California Medical Center, Los Angeles, California.
authors.forename: Jamil
authors.initials: J
authors.lastname: Samaan
authors.forename: Kulmeet
authors.initials: K
authors.lastname: Sandhu
authors.affiliation: Keck Hospital of USC (University of Southern California), University of Southern California Medical Center, Los Angeles, California.
authors.forename: Nikolai
authors.initials: N
authors.lastname: Bildzukewicz
authors.affiliation: Keck Hospital of USC (University of Southern California), University of Southern California Medical Center, Los Angeles, California.
authors.forename: Namir
authors.initials: N
authors.lastname: Katkhouda
authors.affiliation: Keck Hospital of USC (University of Southern California), University of Southern California Medical Center, Los Angeles, California.
authors.forename: John C
authors.initials: JC
authors.lastname: Lipham
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000556:secondary; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
keywords: gastric cancer; gastric carcinoma; signet-cell; stomach neoplasm; young