Skip to main content

Advertisement

SpringerLink
Log in

Analysis of Clinicopathologic Characteristics and Prognosis of Gastric Cancer in Young and Older Patients

  • Method
  • Published:
Pathology & Oncology Research

Abstract

Background

The worldwide incidence of gastric cancer is gradually declining, however it remains the fourth highest in cancer incidence and the second leading cause of cancer death. Gastric cancer in young people is a disturbing problem and the routine screening does not include people less than 35 years. The clinicopathological features of gastric carcinoma are said to differ between young and elderly patients and it is thought that the prognosis of this disease is worse for younger patients. It is also suggested that the diagnosis is usually made later or have a more aggressive behaviour. Although, others report that tumor staging and prognosis for young patients is similar to older patients and depends on whether the patients undergo a curative resection. All these data need more investigation and studies. Although Portugal has a high incidence of gastric cancer, no studies have yet been performed comparing the clinicopathologic features and prognosis of young and elderly patients with gastric cancer.

Aims

This study intend to assess whether the clinicopathological features and prognosis of gastric cancer in young patients (YGC) is similar to older ones (OGC).

Methods

Between 2000 and 2005, 406 patients with histological diagnosis of primary gastric cancer, treated in the Departments of Surgery and Oncology at the Centro Hospitalar of Vila Nova de Gaia / Espinho, were regularly followed at least for five years after surgery. These were reviewed retrospectively. Several variables were analyzed in young patients and compared with the elder ones. We used the chi-square and Fisher to evaluate the statistical association between categorical variables and t-test for numeric variables. Survival was estimated by the Kaplan-Meier method and used the log-rank test to assess differences in survival among different subgroups of patients. The criteria for statistical significance was p < 0.05. Data analysis was performed using the SPSS 18.

Results and Conclusions

With regard to resectability, 78 % of the tumors were resected in the group of younger patients, the surgery more frequently achieved was total gastrectomy with anastomosis in Y of Roux. In the elder group, about 62 % of the tumors were resected and BII gastrectomy was the most frequent surgery. The diffuse adenocarcinoma was the most frequent histological type in younger patients, whereas in older patients was intestinal adenocarcinoma. With regard to the stage in the first group there was a predominance of stages: IA and IV (26.1 %) in the second: IV (25.8 %). The survival for stage III e IV was significantly worst in YGC compared with OGC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Parkin DM (2004) International variation. Oncogene 23:6329–6340

    Article  PubMed  CAS  Google Scholar 

  2. Parkin DM, Bray FI, Devesa SS (2001) Cancer burden in the year 2000, the global picture. Eur J Cancer 37:S4–S66

    Article  PubMed  Google Scholar 

  3. Forman D, Newell DG, Fullerton F, Yarnell JW, Stacey AR, Wald N, Sitas F (1991) Association between infection with Helicobacter Pylori and risk of gastric cancer: evidence from a prospective investigation. BMJ 302:1302–1305

    Article  PubMed  CAS  Google Scholar 

  4. Parsonnet J, Friedman GD, Vandersteen DP, Chang Y, Vogelman JH, Orentreich N, Sibley RK (1991) Helicobacter pylori infection and the risk of gastric carcinoma. N Engl J Med 325:1127–1131

    Article  PubMed  CAS  Google Scholar 

  5. Milne AN, Sitarz R, Carvalho R, Carneiro F, Offerhaus GJ (2007) Early onset gastric cancer: on the road to unraveling gastric carcinogenesis. Curr Mol Med 7:15–28

    Article  PubMed  CAS  Google Scholar 

  6. El-Omar EM, Carrington M, Chow WH, McColl KE, Bream JH, Young HA, Herrera J, Lissowska J, Yuan CC, Rothman N, Lanyon G, Martin M, Fraumeni JF Jr, Rabkin CS (2000) Interleukin-1 polymorphisms associated with increased risk of gastric cancer. Nature 404:398–402

    Article  PubMed  CAS  Google Scholar 

  7. Milne AN, Offerhaus GJA (2010) Early-onset gastric cancer: Learning lessons from the young. World J Gastrointest Oncol 2(2):59–64

    Article  PubMed  Google Scholar 

  8. Correa P, Shiao YH (1994) Phenotypic and genotypic events in gastric carcinogenesis. Cancer Res 54:1941s–1943s

    PubMed  CAS  Google Scholar 

  9. Maehara Y, Emi Y, Tomisaki S, Oshiro T, Kakeji Y, Ichiyoshi Y, Sugimachi K (1996) Age-related characteristics of gastric carcinoma in young and elderly patients. Cancer 77:1774–1780

    Article  PubMed  CAS  Google Scholar 

  10. Theuer CP, de Virgilio C, Keese G, French S, Arnell T, Tolmos J, Klein S, Powers W, Oh T, Stabile BE (1996) Gastric adenocarcinoma in patients 40 years of age or younger. Am J Surg 172:473–476

    Article  PubMed  CAS  Google Scholar 

  11. Hamilton SR, Aaltonen LA. World Health Organization Classification of Tumors. Pathology and Genetics of Tumors of the Digestive System. Lyon, France: IARC Press, 2000: 204

  12. Ramos De la Medina A, Salgado-Nesme N, Torres-Villalobos G, Medina-Franco H (2004) Clinicopathologic characteristics of gastric cancer in a young patient population. J Gastrointest Surg 8:240–244

    Article  PubMed  Google Scholar 

  13. Medina-Franco H, Heslin MJ, Cortes-Gonzalez R (2000) Clinicopathological characteristics of gastric carcinoma in young and elderly patients: a comparative study. Ann Surg Oncol 7:515–519

    Article  PubMed  CAS  Google Scholar 

  14. Matley PJ, Dent DM, Madden MV, Price SK (1988) Gastric carcinoma in young adults. Ann Surg 208:593–596

    Article  PubMed  CAS  Google Scholar 

  15. Kokkola A, Sipponen P (2001) Gastric carcinoma in young adults. Hepatogastroenterology 48:1552–1555

    PubMed  CAS  Google Scholar 

  16. Lim S, Lee HS, Kim HS, Kim YI, Kim WH (2003) Alteration of E-cadherin-mediated adhesion protein is common, but microsatellite instability is uncommon in young age gastric cancers. Histopathology 42:128–136

    Article  PubMed  CAS  Google Scholar 

  17. Maeta M, Yamashiro H, Oka A, Tsujitani S, Ikeguchi M, Kaibara N (1995) Gastric cancer in the young, with special reference to 14 pregnancy-associated cases: analysis based on 2,325 consecutive cases of gastric cancer. J Surg Oncol 58:191–195

    Article  PubMed  CAS  Google Scholar 

  18. Derakhshan MH, Liptrot S, Paul J, Brown IL, Morrison D, McColl KE (2009) Oesophageal and gastric intestinal-type adenocarcinomas show the same male predominance due to a 17 year delayed development in females. Gut 58:16–23

    Article  PubMed  CAS  Google Scholar 

  19. Furukawa H, Iwanaga T, Imaoka S, Hiratsuka M, Fukuda I, Kabuto T, Ishikawa O, Sasaki Y (1989) Multifocal gastric cancer in patients younger than 50 years of age. Eur Surg Res 21:313–318

    Article  PubMed  CAS  Google Scholar 

  20. Suriano G, Oliveira C, Ferreira P, Machado JC, Bordin MC, De Wever O, Bruyneel EA, Moguilevsky N, Grehan N, Porter TR, Richards FM, Hruban RH, Roviello F, Huntsman D, Mareel M, Carneiro F, Caldas C, Seruca R (2003) Identification of CDH1 germline missense mutations associated with functional inactivation of the E-cadherin protein in young gastric cancer probands. Hum Mol Genet 12:575–582

    Article  PubMed  CAS  Google Scholar 

  21. Suriano G, Yew S, Ferreira P, Senz J, Kaurah P, Ford JM, Longacre TA, Norton JA, Chun N, Young S, Oliveira MJ, Macgillivray B, Rao A, Sears D, Jackson CE, Boyd J, Yee C, Deters C, Pai GS, Hammond LS, McGivern BJ, Medgyesy D, Sartz D, Arun B, Oelschlager BK, Upton MP, Neufeld-Kaiser W, Silva OE, Donenberg TR, Kooby DA, Sharma S, Jonsson BA, Gronberg H, Gallinger S, Seruca R, Lynch H, Huntsman DG (2005) Characterization of a recurrent germ line mutation of the E-cadherin gene: implications for genetic testing and clinical management. Clin Cancer Res 11:5401–5409

    Article  PubMed  CAS  Google Scholar 

  22. Carneiro F, Oliveira C, Suriano G, Seruca R (2008) Molecular pathology of familial gastric cancer, with an emphasis on hereditary diffuse gastric cancer. J Clin Pathol 61:25–30

    Article  PubMed  CAS  Google Scholar 

  23. Nakamura R, Saikawa Y, Takahashi T, Takeuchi H, Asanuma H, Yamada Y, Kitagawa Y (2011) Retrospective analysis of prognostic outcome of gastric cancer in young patients. Int J Clin Oncol 16(4):328–334

    Article  PubMed  Google Scholar 

  24. Ramos-De la Medina A, Salgado-Nesme N et al (2004) Clinicopathologic characteristics of gastric cancer in a young patient population. J Gastrointest Surg 8(3):240–244

    Article  PubMed  Google Scholar 

  25. Koea JB, Karpeh MS, Brennan MF (2000) Gastric cancer in young patients: demographic, clinicopathological, and prognostic factors in 92 patients. Ann Surg Oncol 7(5):346–351

    Article  PubMed  CAS  Google Scholar 

  26. Hiyama T, Tanaka S, Yoshihara M, Sasao S, Kose K, Shima H, Tuncel H, Ueno Y, Ito M, Kitadai Y, Yasui W, Haruma K, Chayama K (2004) Chromosomal and microsatellite instability in sporadic gastric cancer. J Gastroenterol Hepatol 19:756–760

    Article  PubMed  CAS  Google Scholar 

  27. Wu M, Semba S, Oue N, Ikehara N, Yasui W, Yokozaki H (2004) BRAF/K-ras mutation, microsatellite instability, and promoter hypermethylation of hMLH1/MGMT in human gastric carcinomas. Gastric Cancer 7:246–253

    Article  PubMed  CAS  Google Scholar 

  28. Hirahashi M, Yao T, Matsumoto T, Nishiyama K, Oya M, Iida M, Tsuneyoshi M (2007) Intramucosal gastric adenocarcinoma of poorly differentiated type in the young is characterized by Helicobacter pylori infection and antral lymphoid hyperplasia. Mod Pathol 20(1):29–34

    Article  PubMed  CAS  Google Scholar 

  29. Chung HW, Noh SH, Lim JB (2010) Analysis of demographic characteristics in 3242 young age gastric cancer patients in Korea. World J Gastroenterol 16(2):256–263

    Article  PubMed  Google Scholar 

  30. Smith BR, Stabile BE (2009) Extreme aggressiveness and lethality of gastric adenocarcinoma in the very young. Arch Surg 144(6):506–510

    Article  PubMed  Google Scholar 

  31. Santoro R, Carboni F, Lepiane P, Ettorre GM, Santoro E (2007) Clinicopathological features and prognosis of gastric cancer in young European adults. Br J Surg 94(6):737–742

    Article  PubMed  CAS  Google Scholar 

  32. Lai JF, Kim S, Li C, Oh SJ, Hyung WJ, Choi WH, Choi SH, Wang LB, Noh SH (2008) Clinicopathologic characteristics and prognosis for young gastric adenocarcinoma patients after curative resection. Ann Surg Oncol 15(5):1464–1469

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal

    Amelia Tavares, Antonio Gandra, Fernando Viveiros, Cassilda Cidade & Jorge Maciel

Authors
  1. Amelia Tavares
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antonio Gandra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fernando Viveiros
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cassilda Cidade
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jorge Maciel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amelia Tavares.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tavares, A., Gandra, A., Viveiros, F. et al. Analysis of Clinicopathologic Characteristics and Prognosis of Gastric Cancer in Young and Older Patients. Pathol. Oncol. Res. 19, 111–117 (2013). https://doi.org/10.1007/s12253-012-9530-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12253-012-9530-z

Keywords

Search

Navigation