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. 2023 Jan 15;7(2):118-127.
doi: 10.1002/jgh3.12860. eCollection 2023 Feb.

Comparisons of pathologic findings and outcomes of gastric cancer patients younger and older than 40: a propensity score matching study in a single center of Korea

Yo H Kim  1 , Yu M Jung  1 , Tae Y Park  1 , Su J Jeong  1 , Tae H Kim  1 , Jin Lee  1 , Jongha Park  1 , Tae O Kim  1 , Yong E Park  1
Affiliations

Comparisons of pathologic findings and outcomes of gastric cancer patients younger and older than 40: a propensity score matching study in a single center of Korea

Yo H Kim et al. JGH Open. .

Abstract

Background and aim: Gastric cancer (GC) is one of the most common cancers worldwide, with a high incidence rate in Korean men. However, comparative studies are scarce on the pathologic findings and treatment effects of GC in patients aged less than 40 years. We evaluated the characteristics and pathologic findings of GC patients aged younger and older than 40 years.

Methods: We retrospectively analyzed 2307 patients diagnosed with GC between January 2010 and May 2018. Eighty-eight (3.8%) and 2219 (96.2%) patients were younger and older than 40 years, respectively. The patients were divided into younger (n = 70) and older (n = 62) age groups through propensity matching.

Results: Overall, compared to the younger group, the older group (n = 2219) had a significantly higher proportion of male patients (66.7% vs 39.8%; P < 0.001) and patients who underwent endoscopic submucosal dissection (ESD) (2.3% vs 23.1%; P < 0.001). However, young patients more often underwent operations compared to older patients (78.4% vs 60.1%; P = 0.001). In the propensity-matched group, older patients more often showed differentiated carcinoma, including well-differentiated (5.7% vs 11.3%) and moderately differentiated (1.4% vs 32.3%). However, younger patients more often showed signet ring cell carcinoma (SRC) (70.0% vs 25.8%). In multivariate analysis, Helicobacter pylori infection (odds ratio, 12.643; 95% confidence interval, 1.068-1449.665; P = 0.044) independently correlated with SRC risk.

Conclusions: Patients below 40 years were more likely to undergo surgery compared to ESD, and pathologic findings were more common in SRC. Therefore, more active screening and H. pylori eradication are needed even in patients aged less than 40 years.

Keywords: Helicobacter pylori; pathology; stomach neoplasms; young adult.

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Figures

Figure 1
Figure 1
Flowchart of patients enrollment.
Figure 2
Figure 2
Distribution of gastric cancer patients over 9 years by age.
Figure 3
Figure 3
Pathologic findings between younger patients and patients over 40 years in propensity‐matched analysis of 132 patients. formula image, ≤40 years; formula image, >40 years.
Figure 4
Figure 4
Cumulative survival rate in case–control‐matched group (Kaplan–Meier graph). formula image, Elderly patients (>40 years); formula image, younger patients (≤40 years).
See this image and copyright information in PMC

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