According to Californian researchers, patients with gastric adenocarcinomas at age 35 years or less appear to have risk of advanced disease and more aggressive tumors at diagnosis.
Dr. Bruce E. Stabile of University of California, Los Angeles, Medical Center, Torrance, and Dr. Brian R. Smith of the University of California, Irvine Medical Center, Orange point out that clinical observation has suggested that very young patients have a far worse prognosis than their older counterparts. The relatively high mortality is largely attributable to the advanced stage of disease at diagnosis regardless of age, they note.
In the study, the researchers retrospectively reviewed data on 350 patients diagnosed with the condition to find whether they also had biologically more aggressive disease.
In all, 30 (9%) patients with age 35 years or less were significantly more likely to have histologic findings of diffuse tumor types (93% versus 69%) than older patients. This was also proved for adjacent organ invasion (74% versus 29%) as well as nodal and distant metastases. The chances of having stage IV disease (90% versus 64%) were also more.
Despite similar operation rates, potentially curative gastrectomy was successful in only 17% of the younger patients compared to 58% of older patients. Postoperative mortality (22% versus 2%) was also high in younger patients.
More over, mean survival was 33.4 months in older patients compared to 11.6 months in younger patients.
Given these findings, the researchers conclude that strategies for earlier diagnosis together with effective new therapies are desperately needed to attenuate the extreme lethality in these uniquely unfortunate patients.