Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China.
Department of General Surgery, Liaoning Cancer Hospital and Institute, Cancer Hospital of China Medical University, Shenyang, People's Republic of China.
J Adolesc Young Adult Oncol. 2020 Aug;9(4):514-521. doi: 10.1089/jayao.2019.0162. Epub 2020 Feb 18.
Whether young patients with gastric cancer (GC) had a distinct prognostic outcome from older patients remains controversial. The objective of this study was to investigate the clinicopathologic characteristics and prognostic factors of young GC patients and evaluate the survival outcome in comparison to their older counterparts. We retrospectively reviewed clinicopathologic and survival data of 2022 patients who underwent curative resection for GC. All patients were divided into the young patient group (18-40 years) and older patient group (>40 years) according to the patient age. Clinicopathologic characteristics and prognostic factors of young GC patients were analyzed, and the survival difference between the two groups was compared. The incidence of GC in the patients 18-40 years of age was 8.1% (164/2022). The young patient group had different clinicopathologic features from the older group, including a significant female predominance, a larger number of retrieved lymph nodes, a higher proportion of undifferentiated histology type, and middle or lower 1/3 GC. However, the survival outcome of young patients was similar to that of their older counterparts (5-year disease free survival [DFS]: 47.0% vs. 44.0%, = 0.247), even when comparison based on the TNM stage was made. Deeper tumor invasion (T3-T4 stage, hazard ratios [HR]: 5.791, 95% confidence intervals [CIs]: 2.908-11.533, < 0.001), lymph node metastasis (HR: 2.500, 95% CIs: 1.308-4.781, = 0.006), and lymphovascular invasion (HR: 2.191, 95% CIs: 1.306-3.677, = 0.003) were independent prognostic factors for young GC patients. Young age (18-40 years) was not associated with poorer survival outcome in GC patients. However, early diagnosis and curative resection with adequate lymphadenectomy will still be necessary for improving the survival outcome of young GC patients.
年轻胃癌患者的预后是否与老年患者不同仍存在争议。本研究旨在探讨年轻胃癌患者的临床病理特征和预后因素，并与老年患者进行比较。
我们回顾性分析了 2022 例接受胃癌根治性切除术患者的临床病理和生存数据。根据患者年龄将所有患者分为年轻患者组（18-40 岁）和老年患者组（>40 岁）。分析了年轻胃癌患者的临床病理特征和预后因素，并比较了两组的生存差异。
18-40 岁年龄组胃癌的发病率为 8.1%（164/2022）。年轻患者组与老年组的临床病理特征不同，包括明显的女性优势、更多的淋巴结检出、更高比例的未分化组织学类型以及中下段胃癌。然而，年轻患者的生存结果与老年患者相似（5 年无病生存率[DFS]：47.0%对 44.0%，=0.247），即使基于 TNM 分期进行比较也是如此。更深的肿瘤侵袭（T3-T4 期，风险比[HR]：5.791，95%置信区间[CI]：2.908-11.533，<0.001）、淋巴结转移（HR：2.500，95%CI：1.308-4.781，=0.006）和血管淋巴管侵犯（HR：2.191，95%CI：1.306-3.677，=0.003）是年轻胃癌患者的独立预后因素。
年轻（18-40 岁）与胃癌患者的生存结果较差无关。然而，早期诊断和根治性切除术加足够的淋巴结清扫术仍将是改善年轻胃癌患者生存结果的必要手段。
