Early Onset Gastric Cancer No Longer Presents as an Advanced Disease with Ominous Prognosis

BACKGROUND: This study aimed to characterize the clinicopathological features and prognosis of early onset gastric carcinomas (EOGCs) in a sample of young Portuguese adults. MATERIAL AND METHODS: A subset of 415 patients submitted to gastric resection was divided into 2 groups: A--patients aged 45 years or less (n = 108), and B--patients older than 45 years (n = 307). The groups were compared for several clinicopathological features and the survival of the patients was analyzed by uni- and multivariate analysis. RESULTS: The surgical resection rate was higher in young patients, in whom tumors more frequently displayed an ulcerative shape (p < 0.001) and diffuse/isolated cell-type histology (p < 0.001). In the elderly, the rate of vascular invasion was significantly higher (p = 0.002). Overall, the survival of young patients was higher than in the elderly (p < 0.001). Survival curves were higher in young patients, except for pT4 and pM1 cases. In the multivariate survival analysis, age (p < 0.001), depth of tumor invasion (p < 0.001), nodal status (p < 0.001), vascular invasion (p = 0.011) and distant metastases (p = 0.007) emerged as independent prognostic factors for gastric carcinoma. CONCLUSION: Young gastric cancer patients no longer present with more advanced disease than the elderly and, overall, survival is better in young patients.