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Clinical characteristics of young age onset gastric cancer in Korea
( Jieun Lee ),( Myung-ah Lee ),( In-ho Kim ),( In Hee Lee ),( Sang Yooung Roh ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Purpose: Gastric cancer is the fourth most common cancer worldwide and more frequently detected in Asian countries including Korea and Japan. The incidence of young-age gastric cancer (GC) is increasing worldwide, but clinical behavior of young-age GC patients is not well established. We retrospectively analyzed the clinical features and outcomes of GC diagnosed at young-age population. Methods: Between Jan. 2009 to Jan. 2015, 163 patients diagnosed as early, advanced, recurrent, or metastatic GC were analyzed. Based on medical records, authors analyzed the clinicopathologic characteristics and survival outcomes including overall survival (OS), disease free survival (DFS), and progression free survival (PFS). Results: One-hundred and four patients (82.8%) patients were diagnosed as GC at their thirties; especially 81 patients (31.2%) patients were diagnosed over 35 years of age. Forty-one (25.6%) patients had familial history of cancer at first or second-degree relatives. Among 41 patients, 19 (46.3%) patients had familial history of GC. The ratio of early GC and advanced GC were relatively similar (47.2% vs. 52.8%, respectively). Among stage II and III patients, 45 patients received 5-FU based adjuvant chemotherapy and recurrence rate was 48.9%. Among patients diagnosed as recurrent or metastatic GC, recurrent GC patients showed relatively superior PFS and OS after cancer recurrence, compared to metastatic GC patients, but without statistical significance. Among metastatic GC patients, patients receiving palliative debulking surgery for ovary metastases showed superior PFS compared to patients who only received palliative systemic chemotherapy (p=0.021, PFS 7.7 vs. 3.37 months, respectively). Conclusions: Young age GC were commonly diagnosed attheir thirties, with preference of familial history for GC. The incidence of advanced GC in young age patients were higher compared to general patient population. Among recurrent GC patients, palliative debulking surgery might have role for superior survival outcomes. Considering relatively higher incidence for advanced GC, active surveillance among young age patients with familial history for gastric cancer is warranted.