Ramos Marcus Fernando Kodama Pertille, Pereira Marina Alessandra, Sagae Victor Masaro Takamatsu, Mester Marcelo, Morrell André Luiz Gioia, Dias Andre Roncon, Zilberstein Bruno, Ribeiro Junior Ulysses, Cecconello Ivan
Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (HC-FM/USP), Instituto do Câncer, São Paulo, SP, Brasil.
Rev Col Bras Cir. 2019 Sep 30;46(4):e20192256. doi: 10.1590/0100-6991e-20192256. eCollection 2019.
to evaluate the clinical and pathological characteristics and survival of young patients with gastric cancer, regardless of the intention of treatment.
we conducted a retrospective analysis of all gastric cancer patients undergoing any surgical treatment between 2008 and 2017. We considered patients under 45 years old as young adults and those over 45 years old, as of advanced age.
of the 875 patients evaluated, 84 (9.6%) were young adults and 791 (90.4%) were older. Younger patients were associated with female gender (p<0.001), lower Charlson score (p=0.002), ASA I/II (p<0.001), diffuse Lauren type (p<0.001) and poorly differentiated tumors (p<0.001). There was no difference between groups regarding treatment intention (palliative versus curative) (p=0.267) and cTNM clinical stage (p=0.120). Disease-free survival was worse in younger individuals (p=0.049), but overall survival was similar between groups (p=0.578). Multivariate analysis identified total gastrectomy, pT3/T4, pN+, and diffuse Lauren type as prognostic factors associated with worse disease-free survival and overall survival. Age was not an independent factor associated with worse prognosis.
although younger patients had lower disease-free survival, overall survival was similar between groups, and age was not a significant independent prognostic factor.
评估青年胃癌患者的临床和病理特征及生存情况，无论其治疗意图如何。
我们对2008年至2017年间接受任何手术治疗的所有胃癌患者进行了回顾性分析。我们将45岁以下的患者视为青年，45岁以上的患者视为老年。
在评估的875例患者中，84例（9.6%）为青年，791例（90.4%）为老年。青年患者与女性性别相关（p<0.001）、Charlson评分较低（p=0.002）、美国麻醉医师协会（ASA）I/II级（p<0.001）、弥漫性劳伦分型（p<0.001）及低分化肿瘤（p<0.001）有关。两组在治疗意图（姑息性与根治性）（p=0.267）和cTNM临床分期（p=0.120）方面无差异。青年患者的无病生存期较差（p=0.049），但两组的总生存期相似（p=0.578）。多因素分析确定全胃切除术、pT3/T4、pN+和弥漫性劳伦分型为与无病生存期和总生存期较差相关的预后因素。年龄不是与预后较差相关的独立因素。
尽管青年患者的无病生存期较低，但两组的总生存期相似，且年龄不是显著的独立预后因素。
