Prognosis and outcomes of management of gastric adenocarcinoma at or below the age of 40 years; NCI experience

Abstract

Background: Gastric cancer has long been assumed to be more advanced and has a worse prognosis in younger people than in older ones. This assumption, however, has never been validated, most likely attributable to the lack of patient numbers for a stage-by-stage survival comparison. Objectives: To present NCI, Cairo University experience in managing young patients (≤ 40 years) with gastric adenocarcinoma Patients and methods: Retrospective cohort study included all cases diagnosed in NCI with gastric adenocarcinoma at or below the age of 40 years in the period from 2010 to 2021. The data included demographic attributes, clinical presentation, investigations and results, adopted treatment modalities, and prognosis of these cases. Results: During the period of the study,30 cases of gastric adenocarcinoma with ages of around 40 years or less have been diagnosed and managed in NCI. Most cases presented in an advanced stage as stage 4 represented 46.7% (14 cases). Seventeen cases (56.7%) underwent surgical exploration, where chemotherapy was taken for twenty-six cases (86.7%). The overall survival showed that patients presented with advanced stage, had omental deposits or ascites had a worse prognosis (P-value = 0.001, <0.001ز Conclusion: Gastric Cancer is aggressive in young age and presents mainly in advanced stage. In terms of overall survival, patients benefit significantly from combined treatment modalities (chemotherapy and surgical resection) compared to receiving only one treatment option.

Keywords

• gastric cancer; adenocarcinoma; young; poor prognosis