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Clinical Features and Survival of Young Adults with Stage IV Gastric Cancer: a Japanese Population-Based Study

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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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Authors and Affiliations

  1. Department of Surgery, Southern Tohoku General Hospital, 7-115 Yatsuyamada, Koriyama City, Fukushima, 963-8563, Japan

    Ryuya Yamamoto, Michitaka Honda, Hidetaka Kawamura, Hiroshi Kobayashi, Yasushi Teranishi & Soshi Hori

  2. Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan

    Michitaka Honda, Hidetaka Kawamura, Hiroshi Kobayashi & Soshi Hori

  3. Department of Surgery, The Takeda Healthcare Foundation, Takeda General Hospital, Aizuwakamatsu, Japan

    Koichi Takiguchi

  4. Department of Surgery, Fukushima Rosai Hospital, Iwaki, Japan

    Atsushi Muto

  5. Department of Surgery, Ohta Nishinouchi Hospital, Koriyama, Japan

    Shigeru Yamazaki

  6. Department of Surgery, Iwaki City Medical Center, Iwaki, Japan

    Satoru Shiraso

  7. Department of Gastrointestinal Tract Surgery, Fukushima Medical University, Fukushima, Japan

    Koji Kono

  8. Department of Surgery, Shirakawa Kosei General Hospital, Shirakawa, Japan

    Takahiro Kamiga

  9. Department of Internal Medicine, Aidu Chuo Hospital, Aizuwakamatsu, Japan

    Toshiyasu Iwao

  10. Department of Surgery, Tsuboi Hospital, Koriyama, Japan

    Naoyuki Yamashita

Authors
  1. Ryuya Yamamoto
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  2. Michitaka Honda
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  14. Naoyuki Yamashita
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Corresponding author

Correspondence to Ryuya Yamamoto.

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Ethics Approval

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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The anonymous nature of the data allowed the requirement for informed consent to be waived.

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All the authors provided consent for the publication of this study.

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The authors declare no competing interests.

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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

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