Abstract
PurposeThe aim of this retrospective study was to probe into clinicopathological features and prognosis of early-onset gastric cancer (EOGC) patients aged ≤ 45 years old.MethodsThis study selected 154 young gastric cancer patients aged ≤ 45 years old and 158 elderly gastric cancer patients aged > 50 years old admitted to West China Hospital of Sichuan University in 2009-2019 as the research object. These patients were further divided into two groups according to whether tumor can be resected radically. The following parameters were analyzed: age, gender, helicobacter pylori (HP) infection status, Her-2 status, pathological type and stage, chemotherapy, tumor differentiation degree, overall survival (OS).ResultsMore than 3,000 patients with gastric carcinoma were screened, and 154 young gastric cancer patients aged ≤ 45 years old were identified as EOGC. Among them, the number of female patients in EOGC group was significantly higher than that of males, accounting for 63.6%. In addition, EOGC were associated with diffuse Laur´en type and poorly differentiated tumors. Interestingly, the Kaplan–Meier method showed that the OS of unresectable EOGC group was significantly lower than that of unresectable LOGC group (P = 0.0005) and chemotherapy containing paclitaxel tended to be more effective in the young people (P = 0.0511). Nevertheless, there was no significant difference in OS between young and elderly patients with gastric cancer in the radical resection group (P = 0.3881).ConclusionEOGC patients have a worse prognosis than late-onset gastric cancer (LOGC) patients with advanced unresectable gastric cancer. Palliative surgery or chemotherapy containing paclitaxel may improve the OS of unresectable young individuals with gastric cancer. Additional randomized controlled trials are required for guiding clinical practice.
Highlights
Gastric cancer is the third leading cause of cancer-related deaths worldwide and half of the deaths from gastric cancer occur in China [1, 2]
According to previous literature and clinical studies, we considered the age of patients ≤ 45 years old as early-onset gastric cancer (EOGC) group, at the same time, those > 50 years old as late-onset gastric cancer (LOGC) group [12, 13]
EOGC group had a larger proportion of women, while the vast majority are men in LOGC group (P < 0.001)
Summary
Gastric cancer is the third leading cause of cancer-related deaths worldwide and half of the deaths from gastric cancer occur in China [1, 2]. Due to the irregular diet and work schedule, the incidence of early-onset gastric cancer (EOGC), diagnosed in young people has significantly increased [4, 5]. There is no clear age limit for early-onset gastric cancer. Regardless of whether it is 30, 40 or 50 years old, the incidence of early-onset gastric cancer is increasing year by year [5]. EOGC is different from late-onset gastric cancer (LOGC) that is traditionally common in the elderly people aged > 60 years old [6]. Studies demonstrated that younger patients commonly have more aggressive pathological assessment and worse outcome compared with older patients in different cancer [9, 10]. Diagnosis and screening of EOGC patients need to be improved [7, 11]
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