J Cancer 2019; 10(2):472-478. doi:10.7150/jca.27517

Research Paper

More attention should be paid to adult gastric cancer patients younger than 35 years old: extremely poor prognosis was found

Wen-Long Guan1*, Lu-Ping Yuan2*, Xiang-Lei Yan2*, Da-Jun Yang2✉, Miao-Zhen Qiu1✉

1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
2. Department of Experimental Research, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
*Wen-Long Guan, Lu-Ping Yuan and Xiang-Lei Yan contributed equally to the manuscript.

Abstract

Purpose: Several studies have reported controversial results about prognosis of gastric cancer in young age patients. The difference may partially result from variable definitions of young age. The aim of this study was to find out the relation between age and prognosis of gastric cancer patients, and to analyze the clinicopathological features and prognostic factors in young gastric cancer patients.

Methods: Data queried for this analysis included GC patients from the Surveillance, Epidemiology, and End Results Program database from 1973 to 2014. Gastric cancer patients (N=79,505) diagnosed with an age≥18 were included. By combining patients with similar prognosis, we figured out 3 cutoff values of age, 35 years old, 65 years old and 75 years old. We divided patients into 4 groups: young age patients: 18-34 years; middle-age patients: 35-64 years; elderly patients: 65-74 years; extremely elderly patients: >74 years. GC patients from Sun Yat-sen University Cancer Center (SYSUCC) were used as external validation data.

Results: The clinicopathological features of young age gastric cancer patients included: poor-differentiated, diffuse type of cancer, and advanced stage at diagnosis. The median survival of patients <35 years old was significantly lower than middle-age patients (35-64 years) and elderly patients (65-74 years) (12 months vs. 15 and 16 months, respectively, both p <0.001). Location of tumor, ethnicity, tumor size, surgery and TNM stage were independent prognostic factors by multivariate analysis in young patients. The poor prognosis for young patients remained valid in the SYSUCC database.

Conclusions: Our results demonstrated that gastric cancer patients <35 years old had an extremely poor prognosis. Early detection of gastric cancer is of paramount importance in young age people.

Keywords: Age, Clinic-pathologic features, Gastric cancer, Prognosis, Young, Clinic-pathologic features

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How to cite this article:
Guan WL, Yuan LP, Yan XL, Yang DJ, Qiu MZ. More attention should be paid to adult gastric cancer patients younger than 35 years old: extremely poor prognosis was found. J Cancer 2019; 10(2):472-478. doi:10.7150/jca.27517. Available from http://www.jcancer.org/v10p0472.htm