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Gastric Adenocarcinoma in Young Patients: a Population-Based Appraisal

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

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.

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Acknowledgment

We thank Maude Veech and Diane Hackett for their assistance with editing this manuscript.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, University of Minnesota and Minneapolis Veteran Affairs Medical Center, Minneapolis, MN, USA

    Waddah B. Al-Refaie MD, FACS

  2. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA

    Chung-Yuan Hu MPH, Peter W. T. Pisters FACS & George J. Chang FACS

Authors
  1. Waddah B. Al-Refaie MD, FACS
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  2. Chung-Yuan Hu MPH
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  3. Peter W. T. Pisters FACS
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  4. George J. Chang FACS
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Corresponding author

Correspondence to Waddah B. Al-Refaie MD, FACS.

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Al-Refaie, W.B., Hu, CY., Pisters, P.W.T. et al. Gastric Adenocarcinoma in Young Patients: a Population-Based Appraisal. Ann Surg Oncol 18, 2800–2807 (2011). https://doi.org/10.1245/s10434-011-1647-x

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  • DOI: https://doi.org/10.1245/s10434-011-1647-x

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