BACKGROUND: Although international studies of young gastric cancer patients have mainly reported favorable survival outcomes compared with older patients, US-based experiences have shown a wider spectrum of outcomes. We examined the impact of young age (under 45 years) on the presentation and survival outcomes of gastric adenocarcinoma. METHODS: A total of 33,236 patients with gastric adenocarcinoma were identified within the 1988-2006 Surveillance, Epidemiology, and End Results (SEER) registry. Multivariate regression analysis of relative survival was performed to adjust for covariate effects using generalized linear models. RESULTS: Young patients were more likely than older patients to have advanced nodal and distant metastatic disease at presentation (P < 0.001 for both). Unadjusted relative survival analysis demonstrated younger patients to have favorable stage-stratified survival when compared with middle-aged and older patients. These findings persisted after adjusting for covariates. After stratifying for receipt of cancer-directed surgery, younger age was associated with more favorable stage-stratified relative survival. CONCLUSIONS: This is the largest US population-based study of age-related gastric cancer outcomes. Although young patients with gastric cancer present with more advanced disease, their adjusted stage-stratified relative survival is more favorable than that of older patients. This study supports a stage-dependent treatment approach in younger populations.
BACKGROUND: Although international studies of young gastric cancerpatients have mainly reported favorable survival outcomes compared with older patients, US-based experiences have shown a wider spectrum of outcomes. We examined the impact of young age (under 45 years) on the presentation and survival outcomes of gastric adenocarcinoma. METHODS: A total of 33,236 patients with gastric adenocarcinoma were identified within the 1988-2006 Surveillance, Epidemiology, and End Results (SEER) registry. Multivariate regression analysis of relative survival was performed to adjust for covariate effects using generalized linear models. RESULTS: Young patients were more likely than older patients to have advanced nodal and distant metastatic disease at presentation (P < 0.001 for both). Unadjusted relative survival analysis demonstrated younger patients to have favorable stage-stratified survival when compared with middle-aged and older patients. These findings persisted after adjusting for covariates. After stratifying for receipt of cancer-directed surgery, younger age was associated with more favorable stage-stratified relative survival. CONCLUSIONS: This is the largest US population-based study of age-related gastric cancer outcomes. Although young patients with gastric cancer present with more advanced disease, their adjusted stage-stratified relative survival is more favorable than that of older patients. This study supports a stage-dependent treatment approach in younger populations.
Authors: J H Choi; H C Chung; N C Yoo; H R Lee; K H Lee; J H Kim; J K Roh; C S Park; J S Min; K S Lee; B S Kim; H Y Lim Journal: Am J Clin Oncol Date: 1996-02 Impact factor: 2.339
Authors: Shaila J Merchant; Joseph Kim; Audrey H Choi; Virginia Sun; Joseph Chao; Rebecca Nelson Journal: Gastric Cancer Date: 2016-02-29 Impact factor: 7.370
Authors: Brian De; Ryan Rhome; Vikram Jairam; Umut Özbek; Randall F Holcombe; Michael Buckstein; Celina Ang Journal: Gastric Cancer Date: 2018-04-24 Impact factor: 7.370
Authors: Raghav Chandra; Neeraja Balachandar; Sam Wang; Scott Reznik; Herbert Zeh; Matthew Porembka Journal: Cancer Gene Ther Date: 2020-10-02 Impact factor: 5.987