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. 2022 Nov 30;14(23):5927.
doi: 10.3390/cancers14235927.

Specifics of Young Gastric Cancer Patients: A Population-Based Analysis of 46,110 Patients with Gastric Cancer from the German Clinical Cancer Registry Group

Markus Kist  1 , Michael Thomaschewski  1 , Yannick Keck  1 , Thaer S A Abdalla  1 , Sylke Ruth Zeissig  2   3 , Kees Kleihues-van Tol  2 , Ulrich Friedrich Wellner  1 , Tobias Keck  1 , Jens Hoeppner  1 , Richard Hummel  1
Affiliations

Specifics of Young Gastric Cancer Patients: A Population-Based Analysis of 46,110 Patients with Gastric Cancer from the German Clinical Cancer Registry Group

Markus Kist et al. Cancers (Basel). .

Abstract

Introduction: 2−8% of all gastric cancer occurs at a younger age, also known as early-onset gastric cancer (EOGC). The aim of the present work was to use clinical registry data to classify and characterize the young cohort of patients with gastric cancer more precisely. Methods: German Cancer Registry Group of the Society of German Tumor Centers—Network for Care, Quality and Research in Oncology (ADT)was queried for patients with gastric cancer from 2000−2016. An approach that stratified relative distributions of histological subtypes of gastric adenocarcinoma according to age percentiles was used to define and characterize EOGC. Demographics, tumor characteristics, treatment and survival were analyzed. Results: A total of 46,110 patients were included. Comparison of different groups of age with incidences of histological subtypes showed that incidence of signet ring cell carcinoma (SRCC) increased with decreasing age and exceeded pooled incidences of diffuse and intestinal type tumors in the youngest 20% of patients. We selected this group with median age of 53 as EOGC. The proportion of female patients was lower in EOGC than that of elderly patients (43% versus 45%; p < 0.001). EOGC presented more advanced and undifferentiated tumors with G3/4 stages in 77% versus 62%, T3/4 stages in 51% versus 48%, nodal positive tumors in 57% versus 53% and metastasis in 35% versus 30% (p < 0.001) and received less curative treatment (42% versus 52%; p < 0.001). Survival of EOGC was significantly better (five-years survival: 44% versus 31% (p < 0.0001), with age as independent predictor of better survival (HR 0.61; p < 0.0001). Conclusion: With this population-based registry study we were able to objectively define a cohort of patients referred to as EOGC. Despite more aggressive/advanced tumors and less curative treatment, survival was significantly better compared to elderly patients, and age was identified as an independent predictor for better survival.

Keywords: early-onset gastric cancer patients; gastric cancer in young patients; german clinical cancer registry group.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Gastric cancer population. Left: dispersion by age. Right: dispersion by age and histopathology; red = intestinal type, green = diffuse type, blue = signet type.
Figure 2
Figure 2
Relative distribution of the three major histological adenocarcinoma subtypes within the population stratified to age percentiles: (A) youngest 50% (<72.4 years); (B) youngest 20% (<60.4 years); (C) youngest 10% (<52.8 years); and (D) youngest 5% (<47.1 years).
Figure 3
Figure 3
Treatment algorithms in both groups EOGC and LOGC.
Figure 4
Figure 4
Kaplan-Meier-Curve for survival for EOGC and LOGC.
See this image and copyright information in PMC

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