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KMID : 0371320050690030217
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Journal of the Korean Surgical Society
2005 Volume.69 No. 3 p.217 ~ p.223
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A Clinicopathological Analysis of Gastric Cancer in Young Patients
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Jun Kyong-Hwa
Im Myoung-Goo
Won Yong-Sung
Cho Hyeon-Min
Heo Youn-Jung
Chin Hyung-Min
Kim Joon-Gi
Park Woo-Bae
Chun Chung-Soo
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Abstract
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Purpose: Gastric cancer is believed to be a disease of the elderly, and rarely occurs in young patients. The aim of this study was to analyze the clinicopathological and prognostic factors related to young gastric cancer patients.
Methods: A total of 877 patients with gastric cancer from 1995 to 2004 in a secondary referral center in Suwon City were enrolled in this study. The clinicopathological features of the young (aged ＜40 years) gastric cancer patients were compared with those of the older (aged ≥40 years) patients. The overall survival was the main outcome measure. The survival curves were constructed using the Kaplan-Meier method, Univariate analysis was performed using the log-rank test, and multivariate analysis was performed using with Cox regression. A P value ＜0.05 was considered significant.
Results: Of the 877 patients, 65(7.4%) were in the young age group. The mean age of this group was 34.9 years (range, 19～39 years). The male-to-female ratio of the patients younger than 40 was 1.24/1; whereas the ratio was 2.07/1 in those older than 40. 7.7 percent of the patients had a family history of gastric cancer. A significantly higher percentage of young patients had a poorly differentiated histology than the older patients (P=0.0001). Twenty-three patients (38.9%) were stage III or IV disease, whereas 36 patients (61.0%) presented with stage I or II disease. A resection with a curative intent was undertaken in 53 patients (81.5%), and a resection with a palliative intent was performed in 12 patients (18.4%). With a mean follow-up of 39 months, the disease-specific 5-year survival rates were similar to those observed in the older group of patients. The variables with a significant impact on survival were a curative resection, a lymph node metastasis, lymphatic invasion, peritoneal metastasis, and adjuvant chemotherapy.
Conclusion: There were no significant differences in the clinicopathological characteristics and clinical outcome of a gastric adenocarcinoma between the younger and older patients. The important prognostic factors were curability, lymph node metastasis, lymphatic invasion, peritoneal metastasis, and adjuvant chemotherapy. (J Korean Surg Soc 2005;69:217-223)
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KEYWORD
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Gastric cancer, Young patients
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