653P - Gastric Cancer in Young Patients - a Single Portuguese Experience

Abstract

ABSTRACT Aim: Gastric cancer (GC) is considered to be a disease of older patients (pts), occurring most frequently in the age group of 50-70 years. Only 2-15% of pts are under 45 years. GC in young pts has more aggressive clinical and pathological features. The role of genetic factors may be more prominent in young people than environmental factors. We aim to describe our experience in young GC management. Methods: Retrospective review of young GC pts (≤45 years) treated at a single Portuguese Cancer Center from 2000-2012. Clinical, pathological, management and survival data were analyzed. Results: Of the 105 pts identified (8% of total GC treated), 19 were excluded because they were treated in other centers. 86 pts had complete data and follow-up at our center; 55.8% were male and mean age was 38.5 ± 0.7years (29.1% under 35 years). 34.4% had smoking habits and 16.3% had a first degree relative with gastric cancer. Main complaints were abdominal pain, weight loss and vomiting. Tumor location was: body – 47.7%, antrum – 44.2%, gastroesophageal junction (GEJ) – 12.8%. Histology: diffuse – 67.4%, intestinal – 26.7%, mixed – 3.5%, squamous cell carcinoma – 2.3%. Stages: I – 19.8%, II – 19.8%, III – 22.1%, IV – 38.4% (peritoneal – 57.6%, hepatic – 39.4%). 23.3% had neoadjuvant chemotherapy (CT). Surgery was performed in 68.6% and 15.3% of them had adjuvant CT. 50% of pts needed palliative chemotherapy (mainly ECF, ECX and Docetaxel). One-year survival was 66.3%, 3-year survival 28% and 5-year survival 19.7%. Median overall survival was 18.4 months (IC95%:14.4-22.5). Conclusions: We found a proportion of young patients with GC similar to the described in the literature. Our patients presented with a high proportion of diffuse histology and more aggressive disease at diagnosis, as already described in other young pts case series. In our results, men/female ratio was 1.26:1, in contrast to other studies that report female predominance. Early mortality was high probably due to high metastatic disease rate at diagnosis, but 3-year survival is similar to historical 3-year survival rate in our Center for all ages GC (31% in 2009). Disclosure: All authors have declared no conflicts of interest.