The majority of gastric cancer-related studies include elderly patients. Studies have shown that gastric cancer carries more poor prognostic factors in younger patients.
In this study we retrospectively reviewed the results of gastric cancer patients under age 30 who had diagnosed and treated at our hospital. Statistical analysis of the study was done by the Kaplan-Meier test, Long Rank test and Cox regression analysis in the SPSS17 statistical program.
824 patients had diagnosed with gastric cancer at our clinic. Of these, 30 (3.6%) patients were under 30 years of age. 17 of them were women (56.6%) and 13 of them were men (43.4%). Of these, the results of 22 patients, 9 males and 13 females, whose data were available, had evaluated. At the time of diagnosis, 5 patients (23%) were stage 2, 6 patients (27%) were stage 3, and 11 patients (50%) had metastatic disease. R0 resection was performed in 10 patients (90.9%) and R2 resection was performed in 1 patient (9.1%). Palliative surgery had performed in 4 (36.3%) of 11 metastatic patients. The tumor was grade 1 in 5,5% of patients, grade 2 in 16,6%, grade 3 in 77,8%. The tumor was diffuse type in 83.3% of patients and intestinal type in 16.6% of patients. The median follow-up was 11 months (2-101 months). Median progression free survival (PFS) was 3 months in metastatic patients, but median PFS was not achieved in non-metastatic patients. The 1 year PFS was 58% (p = 0.001) in non-metastatic patients (Figure 1A). Median overall survival (OS) was 6 months in metastatic patients, and median OS was not achieved in non-metastatic patients (p = 0.001). The estimated OS was 67 months in non-metastatic patients (Figure 1B). Tumor grade, histopathological subtype, presence of lymphovascular and perineural invasion and chemotherapy regimens were not correlated with PFS and OS. There was no correlation between OS and serum CEA, AFP, Ca19-9 and Ca125 levels at the time of diagnosis.
The ratio of gastric cancer under age 30 varies between 1-2% in the literature. In our study, the ratio of patients under 30 years old was 3.6%. Although young patients have more poor prognostic criteria such as diffuse type, proximal location, high grade, and lymphovascular invasion, the survival rates were similar to the elderly patients, according to the other studies in the literature.
Clinical trial identification
Legal entity responsible for the study
Cumhuriyet University Faculty of Medicine.
Has not received any funding.
All authors have declared no conflicts of interest.