Article Abstract

Clinicopathological features and prognosis of younger patients with gastric carcinoma

Authors: Fa-Xiang Dai, Jie-Jie Jin, Wei Wang, Sheng-Jia Yu, Zi-Wen Long, Hong Cai, Xiao-Wen Liu, Ye Zhou, Qiong-Zhu Dong, Ya-Nong Wang, Hua Huang


Background: The incidence rate of gastric carcinoma (GC) in young patients has increased in recent decades in China. The objective of this study was to examine the clinicopathological features and prognosis of younger patients with GC and to investigate the impact of younger age (≤50 years) on the presentation and survival outcomes of patients with GC.
Methods: A total of 411 GC patients, whose operations were performed by the same surgeon, were selected at Fudan University Shanghai Cancer Center. Differences in demographic distribution and clinicopathological features were analysed between 102 younger (≤50 years of age, young group, YG) and 290 old (51–70 years of age, old group, OG) GC patients. In addition, the surgical features and prognosis of the two groups were retrospectively investigated.
Results: The percentage of females in the YG was significantly higher than that in the OG (45.1% and 24.5%, respectively; P<0.001). The distinguishing clinicopathological features between the two groups included gender, depth of invasion, differentiation grade, carcinoembryonic antigen (CEA) level, carbohydrate antigen 19-9 (CA19-9) level and delayed diagnosis. The 5-year disease-specific survival rate of patients in the YG was significantly higher than that in the OG (67.7% and 55.8%, respectively; P=0.048). In the YG, female patients with GC showed a significantly lower disease-specific survival than males (P=0.021). Male patients with GC in the YG showed a significantly higher 5-year disease-specific survival rate compared to female ones (P=0.009), while the same was not found for in the OG (P=0.633). Multivariate analysis revealed that tumor size (≥5 cm), N classification (N2/3), elevated CA19-9 level and sex (Female) were independent negative prognostic factors of GC patients aged ≤50 years old.
Conclusions: In comparison with old patients, young patients with GC show unique features, including a higher percentage of females, a higher percentage of the T1 depth of invasion, undifferentiated histological grade, normal preoperative CA19-9 level and normal preoperative CEA level. In particular, males ≤50 years showed a higher rate of early stage disease with better survival than males aged >50 years, while the prognosis of females aged ≤50 years was as poor as that of females aged >50 years.


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