Department of Gastroenterology, Liaocheng Hospital, Shandong province, China.
Fuxing Hospital, Captital Medicial University.
Medicine (Baltimore). 2023 Aug 25;102(34):e34635. doi: 10.1097/MD.0000000000034635.
An increase trend and a bad prognosis toward gastric cancer (GC) in individuals <40 years have been observed over the past few decades. GC in Young adult needs further evaluation to identify clear risk factors for early screening and better prognosis. A total of 126 young adult patients with gastric cancer (individuals <40 years) (YG) were collected in Liaocheng hospital in China from Jan 2003 to Dec 2019. The overall median follow-up was 96.5 months (rang 1-192 months). Survival was determined by the Kaplan-Meier method and the difference in survival among different subgroups were assessed using the log-lank test. Correlations between risk factors and overall survival were assessed by univariate and multivariate Cox proportional hazards regression analysis. Advanced stage cancer at onset and undifferentiated histologic tumor type were the prominent clinicopathological features of YG. The 5-year overall survival of the YG was 31.7%. The 5-year survival of the YG differed from tumor staging and treatment methods. The 5-year survival was 100% in stage I group, 58.8% in stage II group, 22.6% in stage III group, and 8.3% in stage IV group respectively. The 5-year survival was 52.1% in the curative resection group versus 3.8% in the non-curative resection group. Multivariate analysis displayed that tumor staging (P = .002) and treatment method (P = .034) were 2 independent prognostic predictors for survival. GC in young adult patients have unique clinicopathological features. Upper gastrointestinal endoscopy should regularly perform for young adult especially those symptomatic patients. Early diagnosis and then proceed to a successful curative resection are vital for a better prognosis.
在过去的几十年中,人们观察到<40 岁的个体中胃癌(GC)的发病率呈上升趋势和预后不良。需要对年轻成年人的 GC 进行进一步评估,以确定明确的早期筛查和改善预后的危险因素。共收集了 126 例中国聊城市医院的年轻胃癌患者(年龄<40 岁)(YG),时间从 2003 年 1 月至 2019 年 12 月。总中位随访时间为 96.5 个月(范围 1-192 个月)。采用 Kaplan-Meier 法确定生存情况,采用对数秩检验评估不同亚组间生存的差异。采用单因素和多因素 Cox 比例风险回归分析评估危险因素与总生存的相关性。发病时的晚期癌症和未分化的组织学肿瘤类型是 YG 的突出临床病理特征。YG 的 5 年总生存率为 31.7%。YG 的 5 年生存率与肿瘤分期和治疗方法有关。Ⅰ期组的 5 年生存率为 100%,Ⅱ期组为 58.8%,Ⅲ期组为 22.6%,Ⅳ期组为 8.3%。根治性切除组的 5 年生存率为 52.1%,而非根治性切除组的 5 年生存率为 3.8%。多因素分析显示肿瘤分期(P=0.002)和治疗方法(P=0.034)是生存的 2 个独立预后预测因素。年轻成年患者的 GC 具有独特的临床病理特征。应定期对年轻成年人,特别是有症状的患者进行上消化道内镜检查。早期诊断然后进行成功的根治性切除对于改善预后至关重要。