Kulig Jan, Popiela Tadeusz, Kolodziejczyk Piotr, Sierzega Marek, Jedrys Joanna, Szczepanik Antoni M
1st Department of Surgery, Jagiellonian University Medical College, 40 Kopernika Street, 31-501 Krakow, Poland.
Langenbecks Arch Surg. 2008 Jan;393(1):37-43. doi: 10.1007/s00423-007-0208-z. Epub 2007 Jul 6.
Gastric cancer (GC) is usually diagnosed in the sixth and seventh decade of life, although it may also be found in younger patients. The aim of this study was to analyse the potential differences in demographic and clinicopathological factors between the younger (40 years of age and less) and older (above 40 years) population of GC.
An electronic database covering all gastric cancer patients treated between 1977 and 1998 at eight university surgical centres was reviewed.
Of 3,431 patients treated, 214 (6.2%) were 40 years of age or younger. No differences in tumour staging or location could be identified, but the diffuse type lesions were more common in the younger patients (52.6 vs 29.8%). No differences were found in morbidity and mortality rates, except a higher incidence of cardiopulmonary complications in older patients undergoing stomach resection (6.6 vs 12.3%). Median survival of patients after gastrectomy was 24.7 months (95% confidence interval [CI] 22.7-26.6) and was insignificantly longer in younger (30.8 months, 95%CI 21.0-40.5) than older (24.1 months, 95%CI 22.1-26.1) patients (P = 0.056). Median survival for unresectable cases was 5.4 months (95%CI 5.1-5.7) and was comparable in the younger (median 5.5 months, 95%CI 5.2-5.8) and older (median 4.4 months, 95%CI 3.7-5.1) groups.
GC in young adults demonstrates only minor deviations from the general population with a similar long-term outcome.
胃癌(GC)通常在60和70岁时被诊断出来,尽管也可能在年轻患者中发现。本研究的目的是分析年轻(40岁及以下)和老年(40岁以上)胃癌患者在人口统计学和临床病理因素方面的潜在差异。
回顾了一个电子数据库,该数据库涵盖了1977年至1998年期间在八个大学外科中心接受治疗的所有胃癌患者。
在3431例接受治疗的患者中,214例(6.2%)年龄在40岁及以下。在肿瘤分期或位置方面未发现差异,但弥漫型病变在年轻患者中更为常见(52.6%对29.8%)。在发病率和死亡率方面未发现差异,除了接受胃切除术的老年患者心肺并发症发生率较高(6.6%对12.3%)。胃切除术后患者的中位生存期为24.7个月(95%置信区间[CI]22.7 - 26.6),年轻患者(30.8个月,95%CI 21.0 - 40.5)的中位生存期略长于老年患者(24.1个月,95%CI 22.1 - 26.1),但差异无统计学意义(P = 0.056)。不可切除病例的中位生存期为5.4个月(95%CI 5.1 - 5.7),在年轻组(中位5.5个月,95%CI 5.2 - 5.8)和老年组(中位4.4个月,95%CI 3.7 - 5.1)中相当。
年轻成年人的胃癌与一般人群相比仅有微小差异,长期预后相似。