Survival and prognosis of young adults with gastric cancer

Abstract

OBJECTIVES:Survival data for young adults (YA) with gastric cancer is conflicting and scarce in Brazil. The aim of this study was to compare the clinicopathological factors and survival rates of younger and older patients with gastric cancer.METHODS:Hospital registries for 294 gastric cancer patients from a reference cancer hospital in São Paulo, Brazil, were consulted for the retrieval of clinicopathological information and follow-up time. Patients were placed into the following groups: YA (≤40 years; N=71), older adult (OA: 41 to 65 years; N=129) and elderly (E: ≥66 years; N=94). Differences were assessed through Pearson's χ2 test, Kaplan-Meier analysis, Log rank test and Cox regression.RESULTS:More YA were diagnosed with advanced disease (clinical stage III/IV: 86.7% YA, 69.9% OA, and 67% E); however, fewer E patients underwent surgery (64.3% YA, 72.7% OA, and 52.4% E). The median overall survival among all patients was 16 months, and the overall survival rate was not significantly different among the age groups (p=0.129). There were no significant differences in the disease-free survival rate. Metastatic disease at diagnosis (HR=4.84; p<0.01) was associated with an increased hazard of death for YA.CONCLUSION:Overall survival was similar among age groups. Metastatic disease at diagnosis was the only factor associated with a poorer prognosis in YA. These results suggest that younger patients deserve special attention regarding the detection of early stage disease.

Socio-Demographic Disparities in Gastric Adenocarcinoma: A Population-Based Study

“…This significant difference in gender disparity is unclear, but likely has a component of exposure in addition to genetics. Of note, we found that females had a slightly better OS compared to their male counterparts, as observed in several other population based studies [4,5,15].…”

Incidence, Survival, and Mortality Trends of Cancers Diagnosed in Adolescents and Young Adults (15–39 Years): A Population-Based Study in The Netherlands 1990–2016

“…Likely also related to therapeutic advances are the improvements in survival among AYAs with lung, liver, pancreas, and stomach carcinomas (more prominent in males) [ 64 , 65 , 66 , 67 ]. Nevertheless, survival outcomes for these cancers in AYAs have remained relatively poor (<60%), which is characteristic for these cancer types regardless of patient age [ 52 , 68 , 69 , 70 , 71 , 72 ]. Studies focusing on young patients (not necessarily AYAs), have shown that younger patients (aged < 50 years) with lung, liver, pancreas, and stomach carcinomas are more often diagnosed with more aggressive disease with higher grade, more advanced stage and higher metastatic rates when compared with older populations [ 64 , 65 , 68 , 69 , 70 , 71 , 72 ].…”

“…Nevertheless, survival outcomes for these cancers in AYAs have remained relatively poor (<60%), which is characteristic for these cancer types regardless of patient age [ 52 , 68 , 69 , 70 , 71 , 72 ]. Studies focusing on young patients (not necessarily AYAs), have shown that younger patients (aged < 50 years) with lung, liver, pancreas, and stomach carcinomas are more often diagnosed with more aggressive disease with higher grade, more advanced stage and higher metastatic rates when compared with older populations [ 64 , 65 , 68 , 69 , 70 , 71 , 72 ]. This likely relates in part to delays in diagnosis and higher frequencies of driver mutations (e.g., EGFR and ALK mutations in lung cancer patients) [ 72 , 73 , 74 ].…”

Gastric Cancer in Young Adults: A Different Clinical Entity from Carcinogenesis to Prognosis

“…An electronic search of PubMed was performed from January 2000 to October 2019 to identify studies that compared the clinicopathological characteristics of young and older patients with GC, and the age cut-off was limited to 40. A total of 19 studies were included [2,4,5,[52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67], from which we can draw the following characteristics of GCYA (Table 2): 6.1. A Higher Prevalence in Females.…”