Clinicopathologic characteristics and prognostic of gastric cancer in young patients

Objectives: Gastric cancer (GC) in young patients is thought to exhibit a worse prognosis due to specific clinicopathologic characteristics and delayed diagnosis; however, the data are controversial. This study aimed to analyse the clinicopathologic characteristics and prognostic factors of GC in young patients and to determine whether GC is a different clinical entity in younger vs. older patients.Patients and methods: Clinical data of 3930 gastric cancer patients who underwent radical gastrectomy were retrospectively analysed and divided into two age groups. The younger group consisted of 342 cases of patients aged 40 years or younger at the time of surgery, and the older group included 3588 cases of patients older than 40 years. Clinicopathologic characteristics were compared using Pearson's (2) or Fisher's exact tests, and survival curves were constructed using the Kaplan-Meier method.Results: Clinicopathologic characteristics of the younger group exhibited a predominance of females (p<0.001), diffuse stomach lesions (p=0.014), signet-ring cell type (p<0.001), poorly differentiated histological tumours (p<0.001), Borrmann type IV (p<0.001), mixed Lauren's classification types (p=0.004), and recurrence rate in the gastric remnant (p<0.001). The overall 5-year survival rates in the younger group and older group were 60.8% and 53.7%, respectively (p=0.017). When stratified by TNM stage, the younger group exhibited enhanced 5-year survival at stage IV compared with the older group (26.9% VS. 10.3%, p=0.003).Conclusion: Although younger patients with GC exhibit more aggressive cancer patterns and higher recurrence rate in the gastric remnant, the overall 5-year survival rate may be better than older patients.