Ryuya Yamamoto1, Michitaka Honda2,3, Hidetaka Kawamura2,3, Hiroshi Kobayashi2,3, Koichi Takiguchi4, Atsushi Muto5, Shigeru Yamazaki6, Yasushi Teranishi2, Satoru Shiraso7, Koji Kono8, Soshi Hori2,3, Takahiro Kamiga9, Toshiyasu Iwao10, Naoyuki Yamashita11. 1. Department of Surgery, Southern Tohoku General Hospital, 7-115 Yatsuyamada, Koriyama City, Fukushima, 963-8563, Japan. dragon1119scorpion@gmail.com. 2. Department of Surgery, Southern Tohoku General Hospital, 7-115 Yatsuyamada, Koriyama City, Fukushima, 963-8563, Japan. 3. Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan. 4. Department of Surgery, The Takeda Healthcare Foundation, Takeda General Hospital, Aizuwakamatsu, Japan. 5. Department of Surgery, Fukushima Rosai Hospital, Iwaki, Japan. 6. Department of Surgery, Ohta Nishinouchi Hospital, Koriyama, Japan. 7. Department of Surgery, Iwaki City Medical Center, Iwaki, Japan. 8. Department of Gastrointestinal Tract Surgery, Fukushima Medical University, Fukushima, Japan. 9. Department of Surgery, Shirakawa Kosei General Hospital, Shirakawa, Japan. 10. Department of Internal Medicine, Aidu Chuo Hospital, Aizuwakamatsu, Japan. 11. Department of Surgery, Tsuboi Hospital, Koriyama, Japan.
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.
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.
Authors: C P Theuer; C de Virgilio; G Keese; S French; T Arnell; J Tolmos; S Klein; W Powers; T Oh; B E Stabile Journal: Am J Surg Date: 1996-11 Impact factor: 2.565
Authors: Michitaka Honda; Sandra L Wong; Mark A Healy; Toshifusa Nakajima; Masayuki Watanabe; Shingo Fukuma; Shunichi Fukuhara; John Z Ayanian Journal: J Cancer Date: 2017-07-05 Impact factor: 4.207