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[Clinicopathological features and prognosis of early-onset gastric cancer: a large-scale retrospective real-world study].
Liu, J D; Yang, C L; Jin, P L; Li, B S; Zhao, J J; Li, H J; Wang, X F; Sun, Y H.
Afiliação
  • Liu JD; Department of Gastrointestinal Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
  • Yang CL; Department of Gastrointestinal Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
  • Jin PL; Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
  • Li BS; Department of Gastrointestinal Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
  • Zhao JJ; Department of Gastrointestinal Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
  • Li HJ; Department of Gastrointestinal Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
  • Wang XF; Department of Gastrointestinal Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
  • Sun YH; Department of Gastrointestinal Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Zhonghua Wei Chang Wai Ke Za Zhi ; 27(5): 452-456, 2024 May 25.
Article em Zh | MEDLINE | ID: mdl-38778684
ABSTRACT

Objective:

To clarify the clinicopathological features, prognosis, and recurrence pattern of early-onset gastric cancer (EOGC).

Methods:

Using data from the gastric cancer database of Zhongshan Hospital, Fudan University, we performed a retrospective, large-scale, real-world study of 5046 patients with gastric cancer who had undergone redical or palliative gastrectomy from January 2013 to December 2018, including 425 patients with EOGC (age ≤45 years) and 4621 controls. All those patients were pathologically confirmed adenocarcinoma with complete follow-up of five years. Residue gastric cancer and patients without complete clinical or follow-up data were excluded. We used a combination of outpatient and telephone follow-up, ending in October 2022 (median duration of follow-up 60 months), and compared the clinicopathological features and prognosis of the two groups.

Results:

The clinicopathological features of EOGC included female predominance (61.1% [262/425 vs. 26.3% [1217/4621], χ2=234.215, P<0.001), fewer comorbidities (31.3% [133/425] vs. 58.5% [2703/4621], χ2=34.378, P<0.001), poorer differentiation (90.6% [385/425] vs. 78.2% [3614/4621], χ2=30.642, P<0.001), higher proportion of diffuse type (53.9% [229/425] vs. 18.3% [846/4621], χ2=274.474, P<0.001), higher proportion of T4 stage (44.7% [190/425] vs. 37.5% [1733/4621], χ2=17.535, P=0.001), more lymph node metastases (60.5% [257/425] vs. 53.9% [2491/4621], χ2=6.764, P=0.009), and higher proportion of pathological stage III/IV (47.5% [202/425] vs. 42.4% [1959/4621], χ2=4.093, P=0.043). The 5-year overall survival rates of the EOGC and control groups were 55.1% and 49.1%, respectively. Overall survival was significantly better in the EOGC than in the control group (P<0.001). According to subgroup analysis, the prognosis of pathological stage I/II/III EOGC was better than that of the control group. Recurrence rates were similar in the two groups, whereas patients with EOGC had a higher proportion of peritoneal recurrence (7.8% [33/425] vs. 3.2% [146/4621], χ2=23.741, P<0.001) and a lower proportion of distant metastasis (4.9% [21/425] vs. 8.3% [385/4621], χ2=6.247, P=0.012).

Conclusion:

EOGC has unique clinicopathological features and recurrence patterns and resectable EOGC has a better prognosis, suggesting that patients with EOGC should be actively treated with the focus on preventing peritoneal recurrence.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Gástricas / Gastrectomia / Recidiva Local de Neoplasia Limite: Adult / Female / Humans / Male / Middle aged Idioma: Zh Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Gástricas / Gastrectomia / Recidiva Local de Neoplasia Limite: Adult / Female / Humans / Male / Middle aged Idioma: Zh Ano de publicação: 2024 Tipo de documento: Article