Treatment issues in pediatric gastric adenocarcinoma

Pediatric Intestinal Foregut and Small Bowel Solid Tumors: A Review of 105 Cases

“…This was corroborated by findings from other groups, who found the frequency of aggressive tumor biology, such as poorly differentiated adenocarcinoma and signet ring cell carcinoma, in the pediatric population to be higher than in adults [5,9,12]. We also found that 68.4% of patients presented with regional or distant disease.…”

“…Though traditional statistics have shown primary GI tract malignancies to account for about 5% of pediatric malignancies [1,2], more recent data have shown that alimentary tract primary malignances account for as few as 1.2% of pediatric cancers [3]. We found in our analysis the annual incidence of pediatric foregut and small bowel solid tumors to be approximately 0.027 cases per million, which is lower than recently described [3,9]. There was approximately equal distribution of male and female patients in our study, which is in contrast to past studies, some of which have described males to have increased risk for developing upper GI malignancies, while others found females to be at higher risk [3,10].…”

“…We also found that 68.4% of patients presented with regional or distant disease. This high level of advanced disease has also been reported by other groups, and is most likely due to failure to consider potential GI malignancy in the differential diagnosis for abdominal complaints, thus leading to delay in diagnosis, sometimes in excess of 2 y [3,5,9,10]. McGill et al showed that the delay in diagnosis ranged from 1 to 30 mo, with the mean being about 2.7 mo [12].…”

“…When histologies are evaluated separately, patients with carcinoma had significantly worse survival (17% 5-y and 12% 10-y survival) than patients with sarcoma (87% 5-y and 83% 10-y survival) or NET (86% 5-and 10-y survival) for all tumor sites. Review of past literature demonstrates that primary gastric adenocarcinoma in childhood and adolescence is, in general, associated with poor clinical outcome [5,9]. Some studies report the median survival of approximately 5 mo [9], while others report 9.7 mo, with a range of 5 to 20 mo [12].…”

Primary gastric tumors of infancy and childhood: 54-year experience at a single institution

“…Reports of childhood gastric carcinomas are limited to case reports [35][36][37]. Larger cohorts include younger adults (age b40) [38].…”