Abstract 1468P
Background
Gastric cancer (GC) is an aggressive cancer and is traditionally associated with poor prognosis as 80% of patients are diagnosed at terminal stages. Various studies have reported approximately 5-8% of GC to be diagnosed before the age of 40. In the younger population, it is thought that they have a worse prognosis due to delayed diagnosis with more aggressive tumour behaviour. We aim to highlight the clinicopathological features and treatment outcomes AYA GC in a single-centre high-volume Asian institution.
Methods
Patients aged between 16-39 who first presented to the National Cancer Centre Singapore from 2015 to 2019 with GC were included. Demographic features and clinicopathological characteristics were extracted from our electronic health records in accordance to our institutional review board’s ethical guidelines. 50 AYA patients with gastric malignancies who first presented to National Cancer Centre Singapore between 1st January 2015 to 31st December 2019 were recruited. 3 were excluded from this analysis due to incomplete data.
Results
Median age of diagnosis was 35 years old (n=47). Majority were male patients (53.2%, n=25) and of the Chinese ethnicity (46.8%, n=22). Majority had poor tumour characteristics with 23 patients (48.9%, n=23) having signet ring cell carcinoma. 30 patients (n=34) had Grade 3 poorly differentiated tumours. Majority (68.1%, n=32) were metastatic at diagnosis with peritoneum as the most common site of metastasis (56.2%, n=32). With a median follow up of 11.1 months, the median overall survival (OS) was 27.4 months (range: 0.5– 111.3 months). Median OS was 16.0 months and 28.8 months for men and women respectively (p=0.937). Both men and women had similar poor prognostic factors, including signet-ring cell carcinoma (40% vs 59%; p=0.19), poorly differentiated (G3) histology (81% vs 100%; p=0.094) and prevalence of stage IV disease (72% vs 64%, p=0.54).
Conclusions
AYAs with GC behave differently with a more aggressive disease course. Further studies are needed to address differences in the molecular profile and survival outcomes between AYA patients with GC and an older population. These mutational targets could improve survival and hopefully change the paradigm of disease for selected young patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.