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Background
Gastric adenocarcinoma is considered a disease of the middle aged and elderly and
has been infrequently reported in patients under 40 years of age. The purpose of this
study was to determine the proportion of young patients diagnosed with gastric adenocarcinoma
and to compare the demographic, clinical and pathologic features of younger and older
patients with gastric adenocarcinoma.
Methods
A retrospective cohort study using tumorregistry records of all patients with gastric
adenocarcinoma diagnosed from 1982 through 1996 at a public teaching hospital. Demographic,
clinical, and pathologic comparisons were made between patients younger than 41 years
of age and race- and sex-matched older patients with gastric adenocarcinoma.
Results
Thirty of 203 (15%) cases of gastric adenocarcinoma were diagnosed in patients less
than 41 years (range 23 to 40). Male to female ratio was 1:1. Young patients were
more likely to be black (33% versus 17%, P = 0.04) Both younger and older patients presented with advanced disease, with nearly
half of each group having metastases. Twelve of 29 (41 %) younger patients were operated
on without a histologic diagnosis of gastric adenocarcinoma in contrast to only 1
older patient (P < 0.001). One of 30 (3%) young patients is alive 39 months following gastrectomy.
Twenty patients died and the remaining 9 were lost to follow-up, all with known residual
or recurrent disease. Six-month survival of young patients (23%) was less than older
patients (42%) (P = 0.14). Young patients were more likely to have diffuse histology (80% versus 55%,
P = 0.12). Overt infection with Helicobacter pylori was uncommon in both groups.
Conclusions
Young patients accounted for an unusually high proportion of patients with gastric
adenocarcinoma diagnosed at our public teaching hospital. Young patients were significantly
more likely to be black and less likely to have an accurate preoperative histologic
diagnosis. Both young and older patients presented with advanced disease and had poor
survival. Young patients were more likely to have diffuse histology and had poorer
6-month survival, suggesting a more aggressive variety of the disease in this group.
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Article info
Footnotes
**Presented at the 48th Annual Meeting of the Southwestern Surgical Congress, Scottsdale, Arizona, April 28–May 1, 1996.
Identification
Copyright
© 1996 Excerpta Medica, Inc. All rights reserved. Published by Elsevier Inc.
