P-0050 - Gastric adenocarcinoma in young population: Are there epidemiological differences?

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Cancer in Young Adults
Gastric Cancer
Cancer Aetiology, Epidemiology, Prevention
Presenter German Calderillo
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors G. Calderillo, C. Diaz, E. Ruiz-Garcia, H. Lopez, L. Aguilar José, E. Trejo, A. Herrera
  • Instituto Nacional de Cancerologia, Tlalpan/MX

Abstract

Introduction

Gastric cancer is a common malignancy in Latin-America, Asia and some countries in Europe with high mortality. In recent decades there has been an increased incidence in young people under 50 years, possibly by changes in diet and lifestyle. There are some repots that have considered age as an adverse prognostic factor in several malignancies.

Methods

A retrospective analysis of patients diagnosed with gastric adenocarcinoma evaluated for the Medical Oncology Service from September 1998 to December 2012. A descriptive and comparative analysis of patients 40 years and under (arm A) versus patients over 40 years (arm B). SPSS version 11 was used.

Results

We analyzed 1338 patients diagnosed with gastric adenocarcinoma, 587 were women (43.9%) with a mean age of 52.2 (+ 13.4) years and 751 men (56.1%) with a mean age of 55.8 (+13.6) years (p <0.0001). The principals differences were: 226 (17%) patients in the arm A vs 1112 (83%) patients in the arm B. The histological features of the patients of arm A were: diffuse type in 67.7% (n = 153), intestinal type 10.2% (n = 23), mixed in 3.5% (n = 8), signet ring cells in 58.4% (n = 132) and poorly differentiated in 76.5% (n = 173) versus arm B 40.3% (n = 448), 32.6% (n = 363), 5,6% (n = 56), 43.9% (n = 488) and 43.9% (n = 488) respectively (with p <0.05). For the primary tumor site, there were no differences between groups (stomach vs esophageal gastric junction (p = NS). Stage IV were 71.4% (n = 161) in the arm A versus 59.1% (n = 657) in the arm B (p < 0.05). The principal sites of metastases were: peritoneal carcinomatosis 53.4% (n = 86), ascitis 21.1% (n = 34), liver 186% (n = 34), retroperitoneum 14.2% (n = 23), lung 6.8% (n = 11), ovary 35.1% (n = 32 of 91 women) and neck 7.4% (n = 12) of the arm A versus 41.4% (n = 272, p < 0.05), 18.5% (n = 122, p = ns), 28.3% (n = 186, p < 0.05), 14.9% (n = 98, p = ns), 9.4% (n = 62, p = ns), 17.4% (n = 48 of 276 women, p < 0.05) and 7.6% (n = 50, p = ns) of the arm B, respectively. Overall treatment received the patients with stage IV was: In the arm A, 120 patients received chemotherapy and in 33 cases the best supportive care (BSC) versus arm B, 456 patients received chemotherapy and 162 the BSC.

Conclusion

About 20% of gastric cancer cases occur in patients of 40 years and under, with high percentages of poor prognosis factors: diffuse type adenocarcinoma, signet ring cell, poorly differentiated and stage IV with peritoneal carcinomatosis, ascites and metastasis to ovaries as the main sites. They probably have worse survival.