Adenocarcinoma of the stomach in patients age 35 years and younger: no impact of early diagnosis on survival outcome.

BACKGROUND AND OBJECTIVES

Patients aged 35 years and younger with gastric adenocarcinoma constitute a group of patients who have been observed to have low survival rates as compared with older gastric adenocarcinoma patients. A low index of suspicion for gastric cancer in this age group has been suspected to result in a delay in diagnosis. The use of computed tomography (CT) scanning and endoscopy has become much more common during the past 15 years. We hypothesized that early diagnosis would result in improved survival for these patients.

METHODS

We performed a retrospective study of 127 patients aged 35 years and younger with gastric (median follow-up, 9 months).

RESULTS

High proportions of female patients and Hispanic patients were observed. Overall survival of this group of patients was poor, with a median survival of only 8 months. Comparison of patients diagnosed within 2 months of the onset of symptoms with those diagnosed later revealed no survival advantage to early diagnosis. Similarly, diagnosis within 2 months of presentation to a physician conferred no survival advantage.

CONCLUSIONS

Long-term survival is rare, with a short overall median survival. Early diagnosis conferred no survival advantage. This group of patients should be considered for protocol based multi-modality therapy, even with potentially resectable disease.