Clinicopathological profile and long-term outcome in young adults with gastric cancer: multicenter evaluation of 214 patients

Background and aims 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. Materials and methods An electronic database covering all gastric cancer patients treated between 1977 and 1998 at eight university surgical centres was reviewed. Results 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. Conclusion GC in young adults demonstrates only minor deviations from the general population with a similar long-term outcome.