Abstract
Purpose
With the aging of society, the mean age of patients with gastric cancer (GC) in Japan has increased. However, there are few documented outcomes for young patients with stage IV GC. We investigated the clinical characteristics and prognosis of such patients aged < 40 years using a dataset from an integrated population-based cohort study.
Methods
We conducted this multicenter population-based cohort study to determine whether earlier onset of GC was a poor prognostic factor. We enrolled patients with metastatic GC aged < 40 years (young group) and those aged between 60 and 75 years (middle-aged group). Patients were histologically diagnosed as having gastric adenocarcinoma. We evaluated the overall survival (OS) of both groups and the hazard ratio (HR) for OS based on age. The adjusted HR with 95% confidence interval (CI) was evaluated using the Cox proportional hazards model after adjusting for confounding factors, including sex, histology, number of metastatic lesions, surgical resection, and chemotherapy.
Results
This study enrolled 555 patients. The patients were classified into the young (n = 20) and the middle-aged group (n = 535). The median OS durations were 5.7 and 8.8 months in the young and middle-aged groups, respectively (p = 0.029). The adjusted HR (95% CI) of the young group was 1.88 (1.17–3.04, p = 0.009).
Conclusion
Age was an independent prognostic factor in patients with stage IV GC. Further studies investigating the genomic characteristics of GC and exploring more effective chemotherapeutic agents are required.
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Data Availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Code Availability
The data that support the findings of this study are available from the corresponding author, M. H., upon reasonable request.
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Acknowledgements
We would like to express our gratitude to Seria Sato, Koji Uehara, Nobuko Kanno, Mika Yusa, Kazuhira Saito, Tomoko Oya, Yosinobu Yamazaki, Yoko Endo, Chieko Tairako, and Yumi Inaba for their contribution to data collection.
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All the study procedures were performed in accordance with the ethical standards of the respective committees on human experimentation (institutional and national), as well as with the Declaration of Helsinki of 1964 and its later versions. The study was approved by the institutional review boards of all the participating institutes.
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Yamamoto, R., Honda, M., Kawamura, H. et al. Clinical Features and Survival of Young Adults with Stage IV Gastric Cancer: a Japanese Population-Based Study. J Gastrointest Canc 54, 56–61 (2023). https://doi.org/10.1007/s12029-021-00797-6
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DOI: https://doi.org/10.1007/s12029-021-00797-6