Characteristics and prognosis of young patients with gastric cancer in Slovenia
Abstract
Background: The relationship between prognosis and age of patients with gastric carcinoma is controversial. The purpose of this study was to define the clinicopathological features and prognosis of gastric cancer in young Slovenian adults. Methods: Between January 1992 and January 2009, 772 patients with resected gastric cancer were enrolled in a prospective database. The findings for 58 (7.5 %) patients aged 45 years or less were compared with those of 714 patients aged between 46 and 86 years. Results: We found significant differences in their ASA scores (p < 0.001): the majority of patients in the younger group scored ASA I (93 %), while most of the patients in the older group scored ASA II or III (72 %). In the younger group there were significantly more Lauren diffuse-type carcinomas (63 % versus 36 %; P = 0.007), total gastrectomies (79 % versus 55 %; P = 0.003), and harvested lymph nodes (26 ± 19 versus 21 ± 14; P = 0.02). There were no statistically significant differences in curative resections (86 % versus 85 %), TNM stage distribution and in the rate of perioperative surgical and non-surgical morbidity and mortality. Actuarial 5-year survival rates for the younger and the older groups were 43.8 % and 34.1 % respectively (P = 0.05). Actuarial 10-year survival rates for the younger and the older groups were 37 % and 23.7 % respectively (P = 0.05). The factors associated with adverse 5-year survival in multivariate analysis were higher TNM UICC stage, non-curative resection, higher ASA scores, and N2–3 lymph node metastases. Conclusions: Differences in the ASA scores between the two groups were expected. A second feature was the predominance of the Lauren diffuse type in the younger group. A higher portion of total gastrectomies and harvested lymph nodes were the consequences of the more aggressive surgical approach in younger patients. Survival was better in the younger group of patients, although the outcome is probably more related to stage of the disease at diagnosis than to age.Downloads
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