Annals of Surgical Oncology

, Volume 7, Issue 5, pp 346–351 | Cite as

Gastric Cancer in Young Patients: Demographic, Clinicopathological, and Prognostic Factors in 92 Patients

  • Jonathan B. Koea
  • Martin S. Karpeh
  • Murray F. BrennanEmail author
Original Article


Background: This investigation was undertaken to define the demographic, clinicopathological, and prognostic factors relevant to young patients with gastric adenocarcinoma.

Methods: A prospective database of all patients with gastric cancer who presented to Memorial Sloan-Kettering Cancer Center was started in 1985. Clinical, pathological, and operative records and follow-up data on 92 patients, 40 years of age or younger, with a primary diagnosis of gastric cancer were reviewed.

Results: The mean patient age was 35 6 4.9 years (range, 17–40 years), and 52 were male. The male-to-female ratio of patients younger than 30 was 0.85/1; whereas in those older than 30, the ratio was 1.45/1. Sixty-six percent of the patients were white, 15% Asian, 11% Hispanic, and 8% were black American. Nineteen percent of patients reported a family history of gastric cancer. Sixty-six patients (71%) presented with stage III or IV disease, whereas 13 patients, each, presented with stage I or II disease. Poorly differentiated lesions were present in 71%. Resection with curative intent was undertaken in 47 patients, and resection with palliative intent was performed in 24 patients. Tumor site (proximal vs. distal vs. linitus plastica), advanced T stage, and the presence of nodal disease were significant predictors of disease-free survival on both univariate and multivariate analyses. The mean survival time and disease-specific 5-year survival rates for individual Union International Contre le Cancer tumor stages were similar to those observed in older populations of patients with gastric cancer; and eight patients, who presented with early (T1/T2) node-negative tumors, are alive and well a minimum of 60 months after resection.

Conclusions: The high frequency of a positive family history in young patients suggests an opportunity to identify a high-risk population for screening.


Gastric cancer Familial screening 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    McNeer G. Cancer of the stomach in the young. AJR 1941;45:537–50.Google Scholar
  2. 2.
    Bedikian AY, Khankhanian N, Heilbrun LK, Bodey GP, Stroehlein JR, Valdivieso M. Gastric carcinoma in young adults. South Med J 1979;72:654–6.PubMedGoogle Scholar
  3. 3.
    Bloss RS, Miller TA, Copeland EM III. Carcinoma of the stomach in the young adult. Surg Gynecol Obstet 1980;150:883–6.PubMedGoogle Scholar
  4. 4.
    Bellegie NJ, Dahlin DC. Malignant disease of the stomach in young adults. Ann Surg 1953;138:7–12.PubMedGoogle Scholar
  5. 5.
    Block M, Griep AH, Polard HM. The occurrence of gastric neoplasms in youth. Am J Med Sci 1948;215:398–404.PubMedGoogle Scholar
  6. 6.
    Matsusaka T, Soejima K, Kodama Y, Saito T, Inokuchi K. Carcinoma of the stomach in young adults. Jpn J Surg 1976;6:170–7.PubMedGoogle Scholar
  7. 7.
    Tamura PY, Curtiss C. Carcinoma of the stomach in the young adult. Cancer 1960;13:379–85.PubMedGoogle Scholar
  8. 8.
    Umeyama K, Sowa M, Kamino K, Kato Y, Satake K. Gastric carcinoma in young adults in Japan. Anticancer Res 1982;2:283–6.PubMedGoogle Scholar
  9. 9.
    Hall TJ, Moulder J, Hsu HS, Achord J, Scott-Conner CE. Gastric carcinoma among younger individuals in Mississippi. South Med J 1993;86:302–4.PubMedGoogle Scholar
  10. 10.
    Tso PL, Bringaze WL, Dauterive AH, Correa P, Cohn I Jr. Gastric carcinoma in the young. Cancer 1987;59:1362–5.PubMedGoogle Scholar
  11. 11.
    Matley PJ, Dent DM, Madden MV, Price SK. Gastric carcinoma in young adults. Ann Surg 1988;208:593–5.PubMedGoogle Scholar
  12. 12.
    American Cancer Society. AJCC Cancer Staging Manual. 5th ed. Philadelphia: Lippincott-Raven, 1997.Google Scholar
  13. 13.
    Oota K, Sobin LH. Histological Typing of Gastric and Oesophageal Tumors. Geneva: World Health Organization, 1977:38–9.Google Scholar
  14. 14.
    Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal type carcinoma. Acta Pathol Microbiol Immunol Scand 1965;64:31–49.Google Scholar
  15. 15.
    Borrman R. Geschwulste des magens und duodenums. In: Henske F, Lubarsch O, eds. Handbuch der Speziellen pathogischen Antomie und Histologie. Berlin: Julius Springer, 1926:IV-L864–IV-L871.Google Scholar
  16. 16.
    Kaplan EL, Meier P. Non-parametric estimation from incomplete observation. J Am Stat Assoc 1958;53:457–81.Google Scholar
  17. 17.
    Dupont JB, Lee JR, Burton GR, Cohn I Jr. Adenocarcinoma of the stomach: review of 1497 cases. Cancer 1978;41:941–7.PubMedGoogle Scholar
  18. 18.
    Parsonnet J, Friedman GD, Vandersteen DP, et al. Helicobacter pylori infection and the risk of gastric cancer. N Engl J Med 1991;325:1127–35.PubMedCrossRefGoogle Scholar
  19. 19.
    Armstrong CP, Dent DM. Factors influencing prognosis in gastric carcinoma. Surg Gynecol Obstet 1986;162:343–8.PubMedGoogle Scholar
  20. 20.
    Brennan MF, Karpeh MS. Surgery for gastric cancer: the American view. Semin Oncol 1996;23:352–9.PubMedGoogle Scholar
  21. 21.
    Meyers WC, Damiano RJ, Postlethwait RW, Rotolo FS. Adenocarcinoma of the stomach: changing patterns over the last 4 decades. Ann Surg 1987;205:1–8.PubMedGoogle Scholar

Copyright information

© The Society of Surgical Oncology, Inc. 2000

Authors and Affiliations

  • Jonathan B. Koea
    • 1
  • Martin S. Karpeh
    • 1
  • Murray F. Brennan
    • 1
    • 2
    Email author
  1. 1.Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew York
  2. 2.Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew York

Personalised recommendations