Gastric cancer in the young: An advanced disease with poor prognostic features

Rona, Kais; Schwameis, Katrin; Zehetner, Joerg; Samakar, Kamran; Green, Kyle; Samaan, Jamil S.; Sandhu, Kulmeet; Bildzukewicz, Nikolai A.; Katkhouda, Namir; Lipham, John C.

doi:10.1002/jso.24533

Cited by 71 publications

(85 citation statements)

References 28 publications

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“…Therefore, the challenge of early diagnosis and treatment of GC also extends to young patients. Recent data have revealed that young adults gastric cancer (YAGC) accounts for 2-8% of all cancers 5,6 . Besides the obvious social impact, YAGC calls for more and more interest due to the growing importance attached to the genetic causes of the disease.…”

Section: Introductionmentioning

confidence: 99%

“…The cut-off value of age to define YAGC has been predictably controversial. Frequently, it has been defined between the limits of 40 and 50 years, without a clear reason 5,6,10,11,17,[19][20][21][22] . Takatsu et al 5 These distinct cut-off values may also reflect different national policies for defining and collecting data on cancer cases in adolescents and young adults, including tumor types other than GC 19,23 .…”

Section: Introductionmentioning

confidence: 99%

“…In the present study, we used 45 years, in agreement with most of the papers on YAGC 6,18,20,21,24,25 . Although some authors have proposed that YAGC may be diagnosed at more advanced stages due to protracted endoscopic studies of minor dyspepsia, our data showed similar TNM clinical staging and surgical treatment intent for both groups, which suggests no delay in diagnosis for YAGC 17,22 .…”

Section: Introductionmentioning

confidence: 99%

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Câncer gástrico em adultos jovens: um grupo de pior prognóstico?

Ramos

Pereira

Sagae

et al. 2019

Rev. Col. Bras. Cir.

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RESUMO Objetivo: avaliar as características clínico-patológicas e sobrevivência de pacientes jovens, portadores de câncer gástrico, independentemente da intenção de tratamento. Métodos: análise retrospectiva de todos os pacientes com câncer gástrico submetidos a qualquer tratamento cirúrgico entre 2008 e 2017. Pacientes com idade inferior a 45 anos foram considerados adultos jovens, e aqueles com mais de 45 anos foram definidos como grupo com idade avançada. Resultados: dos 875 pacientes avaliados, 84 (9,6%) eram adultos jovens e 791 (90,4%) tinham idade avançada. Jovens associaram-se ao sexo feminino (p<0,001), menor escore de Charlson (p=0,002), ASA I/II (p<0,001), tipo difuso de Lauren (p<0,001) e tumores pouco diferenciados (p<0,001). Não houve diferença entre os grupos quanto à intenção de tratamento (paliativo versus curativo) (p=0,267) e estádio clínico cTNM (p=0,120). A sobrevida livre de doença foi pior nos jovens (p=0,049), mas a sobrevida global foi semelhante entre os grupos (p=0,578). A análise multivariada identificou gastrectomia total, pT3/T4, pN+ e tipo difuso de Lauren como fatores prognósticos associados a pior sobrevida livre de doença e sobrevida global. A idade não foi um fator independente associado a pior prognóstico. Conclusão: apesar de os jovens apresentarem uma menor sobrevida livre de doença, a sobrevida global foi semelhante entre os grupos, e a idade não demonstrou ser um fator prognóstico independente significativo.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Câncer gástrico em adultos jovens: um grupo de pior prognóstico?

Ramos

Pereira

Sagae

et al. 2019

Rev. Col. Bras. Cir.

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“…Other studies showed similar results, Yin et al [24] reported a slight increase of mortality for gastric cancer in this age group. This increase in mortality can be due to the fact that young patients tend to present themselves in advanced stages associated with pathological characteristics of seal ring carcinoma and poorly differentiated carcinoma; these being related to wrong prognostic factors [25].…”

Section: Mortality In Young Adult Menmentioning

confidence: 99%

Cancer incidence and mortality trends in Metropolitan Lima young adults, 1990–2012

Luna‐Abanto¹,

Ruiz²,

Laura-Martinez³

et al. 2020

ecancer

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Aims: The purpose of this research was to calculate and compare standardised incidence and mortality ratios in young adults, based on the data published by the population-based cancer registry of Metropolitan Lima. Method: A secondary analysis was carried out on the data published by the population-based cancer registry of Metropolitan Lima in its last five volumes. Calculating the standardised incidence ratio, in accordance with the World Health Organization's standard population, was done using the direct method, and the annual percentage change was calculated using the Joinpoint Regression Program. Results: From 1990 to 2012, 12,380 new cases of cancer in young adults between the ages of 20 and 49 were reported in Metropolitan Lima. The neoplasms with the highest standardised incidence ratio in the young adult male group were testicular cancer, brain and nervous system cancer, stomach cancer, non-Hodgkin's lymphoma and bowel cancer. The neoplasms with the highest standardised mortality ratio for this group were stomach cancer, brain and nervous system cancer, non-Hodgkin's lymphoma, tracheal cancer, bronchial and lung cancer and liver cancer. The neoplasms with the highest standardised incidence ratio in the young adult female group were breast cancer, cervical cancer, thyroid cancer, ovarian cancer and brain and nervous system cancer. The neoplasms with the highest standardised mortality ratio for this group were breast cancer, cervical cancer, stomach cancer, brain and nervous system cancer and non-Hodgkin's lymphoma. Conclusions: Young adults represent a highly unique group, characterised by little diagnostic suspicion, distribution and aggressiveness of the neoplasms that occur in them. Assessing and reporting incidence and mortality ratios in this age group can contribute to decision making.

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“…In order to improve the clinical management of such malignancy, studies on exploiting novel pathogenic variations in CDH1 and new susceptibility genes for HDGC in Chinese population are required to further elucidate the molecular mechanism of HDGC. Given that early-onset gastric cancers showed advanced stage of disease with high proportion of poorly differentiated carcinomas (14), and that early age of diagnosis potentially indicate presence of familial and hereditary cancer which may be attributable to genetic factors, therefore, investigating on such group of cancer patients may assist to identify susceptibility genes to gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

Investigation on Gastric Cancer Susceptibility Genes in Chinese Early-onset Diffuse Gastric Cancer

Feng

Zhang

et al. 2020

Preprint

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Abstract BackgroundDiffuse gastric cancer (DGC) is known as gastric cancer with diffuse type morphology. Early onset DGC is an indicator of suspicious hereditary diffuse gastric cancer (HDGC). HDGC patient are often less sensitive to chemotherapy and suffer from highly invasive late stage malignancy with poor prognosis. Such hereditary cancer syndrome is closely related to deleterious CDH1 germline variant. In addition, potential pathogenic germline variants in other candidate genes were also observed in HDGC families. However, the profile of gastric cancer (GC) susceptibility gene in Chinese HDGC patients is yet to be elucidated.MethodsTo investigate gastric cancer susceptibility genes in Chinese gastric cancer patients, we collected peripheral blood samples from 29 patients fulfilled both HDGC clinical diagnosis and genetic testing criteria updated on 2015 by IGCLC. Genomic DNA was extracted from peripheral blood followed by Whole Exome Sequencing (WES) with average sequencing depth of at least 100X. Gastric cancer predisposing SNV and Indel candidates were filtered based on population allele frequencies in public nucleotide polymorphism databases and pathogenic variant filtering process was performed to identify potential gastric cancer predisposing variant candidates. Immunohistochemistry was conducted on biopsies from patient who carries potential pathogenic CDH1 germline variant.ResultsIn general, 336296 germline non-synonymous variants were detected from 29 GC patients. According to the pathogenic variant filtering process, 25 germline variant candidates in 22 genes were identified as gastric cancer predisposing variant candidates. In addition, a novel splice-site variant, c.2165-1G>A (NM_004360.4), in CDH1 was detected in a Chinese early-onset HDGC patient who developed ovarian metastasis. Furthermore, IHC analysis on the ovarian cancer tissue from this patient demonstrated weakly to moderate staining of E-cadherin compared with positive control. Moreover, another two variants, CTNNA1 c.1975_1976del (NM_001903.2), APC c.-19+1G>A (NM_001127511.2), were suspicious of gastric cancer predisposing variants.ConclusionsThis study suggested that CDH1 c.2165-1G>A may act as a gastric cancer predisposing variant. In addition, to further investigate molecular mechanisms of early-onset gastric cancer, one may consider 22 genes observed in this study. Furthermore, the inconclusive results in this study warrant future investigation on gastric cancer susceptibility gene discovery that cohort selection may require more stringent conditions.

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Gastric cancer in the young: An advanced disease with poor prognostic features

Abstract: Early-onset gastric cancer demonstrates advanced stage of disease, and a high incidence of poorly-differentiated and signet-cell type carcinoma. Overall survival is poor with no added benefit to surgical intervention in advanced disease.

Cited by 71 publications

References 28 publications

Câncer gástrico em adultos jovens: um grupo de pior prognóstico?

Câncer gástrico em adultos jovens: um grupo de pior prognóstico?

Cancer incidence and mortality trends in Metropolitan Lima young adults, 1990–2012

Investigation on Gastric Cancer Susceptibility Genes in Chinese Early-onset Diffuse Gastric Cancer

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