GASTRIC ADENOCARCINOMA UNDER THE AGE OF 60: A MULTICENTRIC STUDY FROM SOUTHERN EUROPE

Aims:

In Europe, gastric adenocarcinoma (GC) is commonly regarded as a disease of the elderly. This study aims to assess the proportion, characteristics, and survival of patients diagnosed with GC under the age of 60.

Methods:

This is a retrospective, multicentric, and analytical study conducted at four tertiary hospitals. All patients diagnosed with GC between 2008 – 2015 were included. Demographic, clinical, endoscopic, histologic, and survival data were retrieved. A multivariate analysis was performed to compare GC in young (age ≤60 years) and elderly patients.

Results:

A total of 1,374 GC were included. The mean age was 74 years (SD:11.1) and 62.2% were males. One hundred seventy-seven patients were under the age of 60 (12.9%, 95% CI = 11.2 – 14.8%). GC was frequently encountered as a metastatic disease in both young and elderly patients (Stage IV: 45.7% and 41%, respectively). In the multivariate analysis, alcohol abuse, ASA functional status I-II, diffuse subtype, neoadjuvant, and palliative therapy were independently associated (p < 0.05) with GC≤60 years. No differences were found in 2-year survival (GC≤60: 39% vs. 35%, p = 0.45). Curative- intent surgery, TNM stage I-II, body mass index < 30 kg/m2, and better functional status at diagnosis were independent predictors of survival in GC under the age of 60.

Conclusions:

One out of eight cases of GC were diagnosed below 60 years. Overall survival was poor regardless of age. Factors associated with localized disease correlated with improved survival in younger patients, altogether underlining the urgent need for early diagnosis strategies in Western countries.