Introduction: The incidence of gastric cancer (GC) declined in the past five decades, while an increasing trend has been reported in GC young adult patients (GCYA). We aimed to study the prevalence of GCYA patients (≤45 years) as a function of country, histology, treatment, survival, and compared to gastric cancer in adults (GCA). Methods: We designed an observational, multicentric international retrospective study considering consecutive patients who underwent gastrectomy for GC from January 1st, 2010, to December 31st, 2020, in three centres located in Europe (Italy), South America (Brazil), and Asia (Japan). Over ten years, 1657 patients were collected from three centres. Among them, 156 patients were GCYA and 1501 GCA. Results: Most GCA patients were male (67%), while in GCYA, 56% were female. The median age of GCA was 68 years (p25-p75=59-75) and 39 years (35-42) in the GCYA patients. In the GCYA group, the frequency of diagnoses increased from 3.8% in 2011 to 5.8% in 2020. Indeed, an increase in GC diagnoses has been observed in the young adult group of patients, with a peak around 40 years old. The clinical tumor stage in GCYA was lower in Japan than in Italy, while TNM did not significantly differ among the three centres at pathological examination. Differences in histological classification emerged between the three centres in GCYA patients: in the Italian and Brazilian centres, the predominant histotype was diffuse, while in the Japanese centre, mixed histotype was the most prevalent. No differences were found in the choice of extension of lymphadenectomy, D2 being the main procedure. The Overall survival (OS) in the GCYA group did not differ between the Western centres; in contrast, OS was significantly higher in Japan, with a five-year survival of 86.7% (CI 95%: 0.74-0.93) (p=0.034). Conclusions: Over the past ten years, new diagnoses peaked at ages less than 50 years. This new trend can be found in countries with different ethnicity and risk factors for Gastric Cancer development. Screening programs focused on young people should be planned.
Gastric Cancer in the young adult. New incidence from east to west?
Lorena Torroni
;
2023-01-01
Abstract
Introduction: The incidence of gastric cancer (GC) declined in the past five decades, while an increasing trend has been reported in GC young adult patients (GCYA). We aimed to study the prevalence of GCYA patients (≤45 years) as a function of country, histology, treatment, survival, and compared to gastric cancer in adults (GCA). Methods: We designed an observational, multicentric international retrospective study considering consecutive patients who underwent gastrectomy for GC from January 1st, 2010, to December 31st, 2020, in three centres located in Europe (Italy), South America (Brazil), and Asia (Japan). Over ten years, 1657 patients were collected from three centres. Among them, 156 patients were GCYA and 1501 GCA. Results: Most GCA patients were male (67%), while in GCYA, 56% were female. The median age of GCA was 68 years (p25-p75=59-75) and 39 years (35-42) in the GCYA patients. In the GCYA group, the frequency of diagnoses increased from 3.8% in 2011 to 5.8% in 2020. Indeed, an increase in GC diagnoses has been observed in the young adult group of patients, with a peak around 40 years old. The clinical tumor stage in GCYA was lower in Japan than in Italy, while TNM did not significantly differ among the three centres at pathological examination. Differences in histological classification emerged between the three centres in GCYA patients: in the Italian and Brazilian centres, the predominant histotype was diffuse, while in the Japanese centre, mixed histotype was the most prevalent. No differences were found in the choice of extension of lymphadenectomy, D2 being the main procedure. The Overall survival (OS) in the GCYA group did not differ between the Western centres; in contrast, OS was significantly higher in Japan, with a five-year survival of 86.7% (CI 95%: 0.74-0.93) (p=0.034). Conclusions: Over the past ten years, new diagnoses peaked at ages less than 50 years. This new trend can be found in countries with different ethnicity and risk factors for Gastric Cancer development. Screening programs focused on young people should be planned.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
