Abstract
BackgroundIt has been suggested that distal gastric carcinoma (GC) in younger patients has a more aggressive outcome than in older patients, however this is a controversial issue. The aim of this study was to compare clinicopathological features between younger and older patients with GC in Northeastern Brazil.MethodsA total of 207 patients with distal GC (41 patients ≤45 years, considered younger group, and 166 > 45 years, considered older group) were evaluated prospectively during a 6 year period.ResultsThe mean patient age in the young group was 37.41 years old and 64.43 years in the older group. No significant difference was found regarding gender, area of residence, history of alcohol consumption, chronic tobacco smoking. Prevalence of first-degree GC history was 12.5% (7.3% in younger group vs. 13.9% in older; p < 0.46). The most frequent symptom was gastric pain and weight loss. Diffuse infiltrative cancer was more frequently seen in younger patients (70.70% vs. 33.70%, respectively; p < 0.01), as was histologically less differentiated tumors (63.40% vs. 33.10%; p < 0.01) and stage IV of GC (48.80% vs. 30.70%; p < 0.015). Five-year survival, evaluated in 82 patients, was lower in younger patients (p = 0.045); however, after adjusting for stage of GC in the multivariate analysis, this association did not remain significant. Family history of GC and gender had no impact on survival.ConclusionsYounger patients showed higher prevalence of diffuse type of Lauren and lower survival that was attributed to higher rate of advanced stage of GC. Gastric cancer screening strategies should also be considered in younger individuals, especially in areas of high prevalence. Further studies are warranted to determine risk factors associated with gastric cancer in young adults.
Highlights
It has been suggested that distal gastric carcinoma (GC) in younger patients has a more aggressive outcome than in older patients, this is a controversial issue
Young patients often present with more advanced GC stage, possibly as a result of delayed diagnosis, and have higher rates of histologically undifferentiated tumors, which have been demonstrated in different patient populations
The purpose of the present study was to evaluate the clinical pathologic characteristics and risk factors associated with distal gastric cancer as well as survival in young patients, defined as 45 years old or less, in comparison with patients above 45 years old, in a referral center of Fortaleza, in the Northeast of Brazil
Summary
It has been suggested that distal gastric carcinoma (GC) in younger patients has a more aggressive outcome than in older patients, this is a controversial issue. Gastric cancer is more common in older patients, with mean age ranging between 50 and 70 years [1, 2]. It is considered a rare disease in young individuals, some studies have shown. Some studies have reported a more aggressive biological pattern with more rapid disease progression and worse prognosis in young GC patients than in middle-age patients [9], other studies did not find such an association [4,5,6, 10]
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