Clinical characteristics and comparison of the outcome in young versus older patients with upper gastrointestinal carcinoma

Abstract

Background The clinical behaviour and outcome of young patients with gastroesophageal tumours (GET) is surmised to differ from older patients, yet data on the comparison of these two patient subgroups is scarce. This study focuses on the investigation of the clinical characteristics and survival outcome of younger-age people with GET, when compared to older patients. Methods Patients diagnosed with GET at the Medical University of Vienna between 2004 and 2016 were included in this study. Clinical parameters and the overall survival (OS) were compared between young (≤ 45 years) and elderly (≥ 65 years) patients. Results Among 796 patients, who were eligible for this analysis, fifty-eight patients (7%) were ≤ 45 years at the initial onset of the disease. These 58 young patients were then matched to elderly patients based on the gender, tumour stage, histology and tumour location. The number of metastatic lesions was significantly higher among young patients ( p < 0.05). In a non-metastatic setting younger patients showed a significant longer OS than older patients (median 1226 versus 801 days, p = 0.028). Furthermore, young patients with extensive metastatic disease (2 or more metastatic site) had a significantly poorer OS than elderly patients (median 450 versus 646 days, p = 0.033). Conclusion These results indicate that young patients might be diagnosed very late, which might lead to the development of a more aggressive disease compared to older patients, but a relatively long OS when diagnosed and treated in a non-metastatic setting. Thus, screening methods for younger patients might be considerable to enhance the outcome of young patients with GET.

STROBE-clinical characteristics and prognosis factors of gastric cancer in young patients aged ≤30 years

“…In our study, the 5 year survival of young patients was very poor (14.1%), the 1-year and 3-year survival rates for the 99 cases were 67.7% and 24.2%, respectively. Young GC patients showed poor prognosis, which was consistent with the results of Puhr et al [46] Their study showed that the 5 year survival of patients under 45 years was 17%. Our study found that TNM stage was significantly associated with the prognosis of young GC ( P < .05), which was also consistent with previous studies, [9] suggesting a pivotal importance of early diagnosis.…”

Latin American young patients with gastric adenocarcinoma: worst prognosis and outcomes

“…In addition, at the multivariate analysis, age (≤40 years), gender (female), clinical stage (IV), and primary tumor location (gastric) remained predictors of worst prognosis and OS. These variables have also been correlated among other studies including different population such as Chinese ( 9 , 35 ), Korean ( 3 ), American ( 29 , 34 ), and European ( 37 , 38 ), concluding that young female patients are commonly diagnosed at a metastatic stage of the disease and have worst outcome and higher risk of death.…”

“…This information shows that young female patients are predominantly diagnosed at metastatic disease stage (59%), with tumor location at stomach (70%), histological classification of diffuse type (68%), signet ring cell component (72%); and poor differentiation (90%). All clinical features related to a bad prognosis of OS and outcome in other studies worldwide ( 14 , 24 , 35 ). Thus, we performed a sub-analysis regarding clinical stage of the disease.…”

Early-onset gasrtric cancer (review)

“…L. Cheng et al продемонстрировали, что показатели общей 5-летней выживаемости среди двух возрастных подгрупп 18-49 и 50-59 лет составили 62,4 и 70,8 % (p=0,019), с неудовлетворительными данными в отношении 5-летней безрецидивной выживаемости -75,2 и 82,8 % (p=0,040), сопряженными с высокими рисками метахронного перитонеального интраабдоминального рецидива, диагностируемыми в 3 раза чаще у более молодых пациентов (15,1 и 5,2 %, p<0,01) [31]. H.C. Puhr et al сообщают, что при сопоставимых критериях отбора, включающих пол, морфологию опухоли, локализацию и распространенность патологического процесса, медиана ОВ с локализованной и местнораспространенной формами больных РЖ в младшей (до 45 лет) и старшей (от 65 лет и старше) возрастных группах составила 41,8 и 26,7 мес (p=0,028), а при наличии синхронных интра-либо экстраабдоминальных метастазов -15 и 21,5 мес (p=0,033) [32]. В одном из китайских исследований при сравнении пациентов с РЖ до 45 и старше 50 лет за период 3-летнего наблюдения в группах радикально оперированных больных не выявлено существенной разницы при оценке общей выживаемости, составляющей 70,4 и 75,9 % (p=0,3881) при сопоставимых показателях регионарного рецидива либо отдаленного метастазирования -40,7 и 43,5 % (p=0,514) [33] [36].…”