Clinicopathological Characteristics, Survival Outcomes, and Genetic Alterations of Younger Patient With Gastric Cancer: Results From China National Cancer Center and cBioPortal

Abstract

BackgroundSurvival outcomes of younger patients with gastric cancer (GC) remains controversial. The present study sought to explore clinicopathological characteristics, survival outcomes, and genetic alterations in the younger and older patients with GC.MethodsPatients with GC were identified from the China National Cancer Center Gastric Cancer Database (NCCGCDB) during 1998–2018. Survival analysis was conducted via Kaplan-Meier estimates and Cox proportional hazards models. Sequencing data were enrolled from the China National Cancer Center, TCGA, and MSKCC databases. ResultsA total of 1146 younger and 16988 older cases were included. Patients in the younger group were predominant in poor differentiation (53.7% versus 33.8%, P<0.0001), and pTNM stage IV (19.5% versus 11.8%, P<0.001). The 5-year overall survival (OS) of patients in NCCGCDB has noticeable increased from 1998 to 2018. Younger age was an independent prognostic factor for GC patients in pTNM stage III (P=0.014), while other stages showed no difference. Compared to the younger, older patients had a higher mutation frequency in LRP1B, GNAS, APC, KMT2D genes (all P< 0.05). In addition, although no significant difference, results of the China National Cancer Center, TCGA, and MSKCC cohorts indicated that younger patients dominated in CDH1, RHOA, and CTNNB1 mutations.ConclusionsStable proportion of younger cases and noticeable survival improvements were reported in the China National Cancer Center. Younger patients with pTNM stage III had a worse survival than older, while other tumor stages showed no difference. Furthermore, distinctive molecular characteristics were identified in younger GC patients, which might partly explain histopathological behaviors and prognosis of in this subpopulation.