CL patients examined during the 20 years from January 1963 to December 1982, we have reviewed 4,928 cases(33.3%). of gastric cancer among 14,817 malignancies. We found 120 cases of gastric cancer in persons below 30 years of age among the 4,928 cases of gastric malig-nancies, which were confirmed by histopathological study at Presbyterian Medical Center in Chon ju.
1) Among the gastric malignancies the incidence of gastric cancer in young adults was 2.4%.
2) The ages ranged from 13 years to 30 years, and the peak incidence occurred in the second decade.
3) Male to female ratio was 1. 15: 1.
4) The clinical symptoms in decreasing order of frequency were epigastric discomfort or pain, indigestion, weight loss, nausea and vomiting, anorexia, epigastric fullness, hematemesis or melena, diarrhea, constipation, dysphagia and bowel habit change.
5) About 44% of the patients visited the hospital within 6 months after onset of symptoms, and 42. 1% of patients after more than 1 year. Physical examination revealed the following in order of frequency: epigastric tenderness, anemia, palpable mass, ascites, abdominal distension, rectal shelf, Virchow´s node, cachexia, hepatomegaly and jaundice.
6) About 35% of the patients did not undergo exploratory operation due to poor general condition, distant metastasis, or refusal of operation, and thus the operation rate was 64.9%. At the time of abdominal exploration, 47.3% were found to have unresectable lesions and underwent a biopsy(23.0%) or a palliative procedure (24.3%) only. Resectability was 52.7%.
7) Of 39 cases of resectable cancer, 22 cases underwent radical operations. The 5-year survival rate of curative resection cases was about 54%. 8) Postoperative complications occurred in 31% of the patients. In order of frequency they
were lung problems, wound infection, intestinal obstruction, and reflux esophagitis. The operative mortality rate was 8. 1%.
9) Tumors were located in the pylorus & antrum (55.4%), body (29.7), cardia & fundus (8. 1%), and linitis plastica(6.8%). The survival rate was high when the tumor was in the cardia or fundus.
10) About 10. 8% of the tumors were found to be limited to the stomach. Thus 89.2% of the tumors penetrated the wall and spread to the surrounding tissues or metastasized to the lymph nodes or other organs.
11) Of 74 gastric malignancies, 74(98.6%) were carcinoma. The survival rate was higher in well-differentiated adenocarcinoma than in poorly differentiated adenocarcinoma.
12) According to the TNM postsurgical-pathological stage grouping, the patients were staged as follows: Stage I-2.9%, II-8.8%, III-33.9%, and IV-54.4%. Survival at 5 years was influenced by tumor location and extent of gastric resection but was most significantly related to the stage of disease at operation(Stage 1-100%, Stage 11-100%, Stage III-6.3%, Stage IV-0%) and to the status of regional nodes (positive 2.6%, negative l00%).
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