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. 2022 Aug;11(16):3057-3073.
doi: 10.1002/cam4.4669. Epub 2022 Mar 22.

Clinicopathological characteristics, survival outcomes, and genetic alterations of younger patients with gastric cancer: Results from the China National Cancer Center and cBioPortal datasets

Penghui Niu  1 , Huang Huang  1 , Lulu Zhao  1 , Tongbo Wang  1 , Xiaojie Zhang  1 , Wanqing Wang  1 , Yawei Zhang  1 , Chunguang Guo  1 , Dongbing Zhao  1 , Yingtai Chen  1
Affiliations

Clinicopathological characteristics, survival outcomes, and genetic alterations of younger patients with gastric cancer: Results from the China National Cancer Center and cBioPortal datasets

Penghui Niu et al. Cancer Med. 2022 Aug.

Abstract

Background: The survival outcomes of younger patients with gastric cancer (GC) have remained controversial. This study explores the clinicopathological characteristics, survival outcomes, and genetic alterations of younger and older patients with GC.

Methods: Patients with GC were identified from the China National Cancer Center Gastric Cancer Database (NCCGCDB) during 1998-2018. Survival analysis was conducted using Kaplan-Meier estimates and Cox proportional hazards models. Sequencing datasets were enrolled from The Cancer Genome Atlas (TCGA) and Memorial Sloan-Kettering Cancer Center (MSKCC) databases.

Results: A total of 1146 younger (<40 years of age) and 16,988 older (≥40 years of age) cases were included in the study. Younger patients had more poorly differentiated lesions than older patients (53.7% vs. 33.8%, respectively; p < 0.0001), and were more often pTNM stage IV (19.5% vs. 11.8%, respectively; p < 0.001). The 5-year overall survival (OS) of patients from the NCCGCDB increased from 1998 to 2018. Younger patients with pTNM stage III had a lower survival rate than older patients (p = 0.014), while no differences by age were observed at other stages. The mutation frequency of the LRP1B, GNAS, APC, and KMT2D genes was higher for older than younger patients (p < 0.05 for all genes). While not significantly different, younger patients from the TCGA and MSKCC databases were more likely to have CDH1, RHOA, and CTNNB1 gene mutations.

Conclusions: A stable proportion and improved survival of younger patients were reported using NCCGCDB data. Younger patients with pTNM stage III had lower rates of survival than older patients. Distinct molecular characteristics were identified in younger GC patients which may partly explain the histopathology and prognosis specific to this subpopulation.

Keywords: clinicopathological characteristics; gastric cancer; genetic alterations; survival outcomes; younger patient.

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Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm‐20‐2554a). The authors have no conflict of interest to declare.

Figures

FIGURE 1
FIGURE 1
Changing trends of the proportion of younger and older groups by period and pTNM tumor stage
FIGURE 2
FIGURE 2
Survival trends between younger and older groups during 20 years. (A) The 5‐year overall survival. (B) The 5‐year progression‐free survival
FIGURE 3
FIGURE 3
Kaplan–Meier survival curves of gastric cancer patients between YG and OG. (A) Kaplan–Meier survival curves of patients in pTNM stage I. (B) Kaplan–Meier survival curves of patients in pTNM stage II. (C) Kaplan–Meier survival curves of patients in pTNM stage III. (D) Kaplan–Meier survival curves of patients in pTNM stage IV
FIGURE 4
FIGURE 4
Comparison of mutation frequencies between younger and older groups from the TCGA and MSKCC databases
See this image and copyright information in PMC

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