Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Unique Features of Gastric Cancer in Young Patients: Experience from a General Hospital in Nepal

  • Kandel, Bishnu Prasad (Department of Surgery, Maharajgunj Medical Campus, Institute of Medicine) ;
  • Singh, Yogendra Prasad (Department of Surgery, Maharajgunj Medical Campus, Institute of Medicine) ;
  • Ghimire, Bikal (Department of Surgery, Maharajgunj Medical Campus, Institute of Medicine)
  • Published : 2016.05.01
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Abstract

Background: Gastric cancer, the fifth most common malignancy in the world, usually affects older individuals but can occur in younger age groups. In this study we compared the clinicopathological profile of young patients of gastric cancer with that of older patients. Materials and Methods: It is a prospective study of gastric cancer patients treated over three year period (January 2012 to December 2014). Data of patients were obtained from the medical record. Clinical and pathological characters of younger patients (age 40 years or less) were compared with older patients (age more than 40 years). Results: There were total of 152 patients treated during the study period. Twenty patients (13.2%) were less than 40 years of age and 132 (86.8%) were older. The male to female ratio in younger patients was 1:1.5 whereas in older patients it was 1:0.6. In the younger age group 14 patients (70%) had poorly differentiated adenocarcinoma in contrast to 45% in the older age group (p<0.01). Some 55% of younger and 42% of older patients had stage IV disease at presentation and curative surgery was not possible. Palliative surgery for gastric outlet obstruction or bleeding from the tumor was performed on 25% and 21% respectively. Conclusions: Gastric cancer in young people aged less than 40 years has unique characters like female predominance, unfavorable tumor biology, and advanced stage at presentation. There should be a high index of suspicion of gastric cancer even in young patients.

Keywords

References

  1. Crew K D, Neugut A I ( 2006). Epidemiology of gastric cancer. World J Gastroenterol, 12, 354-62. https://doi.org/10.3748/wjg.v12.i3.354
  2. Dhobi M A, Wani K A, Parray F Q, et al (2013). Gastric cancer in young patients. Int J Surg Oncol, 2013, 981654.
  3. Edge S B, Compton C C (2010). The american joint committee on cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol, 17, 1471-4. https://doi.org/10.1245/s10434-010-0985-4
  4. Eskandar H, Hossein M, Rahim M, et al (2006). Clinical profile of gastric cancer in Khuzestan, southwest of Iran. World J Gastroenterol,14, 4832-5.
  5. Ferlay J, Soerjomataram I, Ervik M, et al (2013). GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013.
  6. Ghimire B, Singh Y P, Timalsina S (2014). Post operative diagnosis of early gastric cancer in a low risk population and the possibility of risk stratified screening. Kathmandu Univ Med J, 45, 32-7.
  7. Hamashima C, Shibuya D, Yamazaki H, et al (2008). The Japanese guidelines for gastric cancer screening. Jpn J Clin Oncol, 38, 259-67. https://doi.org/10.1093/jjco/hyn017
  8. Katai H, Sasako M, Sano T, et al (1996). Gastric carcinoma in young adults. Jpn J Clin Oncol, 26, 139-43. https://doi.org/10.1093/oxfordjournals.jjco.a023197
  9. Lai J F, Kim S, Li C, et al (2008). Clinicopathologic characteristics and prognosis for young gastric adenocarcinoma patients after curative resection. Ann Surg Oncol, 15,1464-9. https://doi.org/10.1245/s10434-008-9809-1
  10. Matley PJ, Dent DM, Madden MV, et al (1988). Gastric carcinoma in young adults. Annals of Surgery, 208, 593-6. https://doi.org/10.1097/00000658-198811000-00008
  11. Medina A R, Salgado-Nesme N, Torres-Villalobos G, et al (2004). Clinicopathologic characteristics of gastric cancer in a young patient population. J Gastrointestinal Surg, 8, 240-4. https://doi.org/10.1016/j.gassur.2003.12.009
  12. Moghimi-Dehkordi B, Safaee A, Pourhoseingholi M A, et al (2008). Statistical comparison of survival models for analysis of cancer data. Asian Pac J Cancer Prev, 9, 417-20.
  13. Nagini S (2012). Carcinoma of the stomach: A review of epidemiology, pathogenesis, molecular genetics and chemoprevention. World J Gastrointestinal Oncol, 4, 156-69. https://doi.org/10.4251/wjgo.v4.i7.156
  14. Nam J.H, Choi, J, Cho S, et al (2012) Association of the Interval between Endoscopies with Gastric Cancer Stage at Diagnosis in a Region of High Prevalence. Cancer, 118, 4953-60. https://doi.org/10.1002/cncr.27495
  15. Pradhananga KK, Baral M, Shrestha BM (2009). Multi-institution hospital-based cancer incidence data for Nepal - An initial report. Asian Pac J Cancer Prev, 10, 259-62.
  16. Sah J K, Singh Y P, Ghimire B (2015). Presentation and outcomes of gastric cancer at a university teaching hospital in Nepal. Asian Pac J Cancer Prev, 16, 5385-8 https://doi.org/10.7314/APJCP.2015.16.13.5385
  17. Saito H, Takaya S, Fukumoto Y,et al (2012).Clinicopathologic characteristics and prognosis of gastric cancer in young patients. Yonago Acta Med, 55, 57-61.
  18. Santoro R , Carboni F, Lepiane P, et al (2007). Clinicopathological features and prognosis of gastric cancer in young European adults. British J Surg, 94, 737-42. https://doi.org/10.1002/bjs.5600
  19. Shrestha UK, Ghos A, Alurkar VM, et al (2013). Prevalence of Helicobacter pylori infection, its correlation with gastroduodenal diseases and the incidence of gastric cancer in Nepal. J Advances Internal Med, 2, 52-60.
  20. Smith BR, Stabile BE (2009). Extreme aggressiveness and lethality of gastric adenocarcinoma in the very young. Arch Surg, 144, 506-10. https://doi.org/10.1001/archsurg.2009.77
  21. Tso PL, Bringaze WL, Dauterive AH, et al.(1987). Gastric carcinoma in the young. Cancer, 59, 1362-5. https://doi.org/10.1002/1097-0142(19870401)59:7<1362::AID-CNCR2820590722>3.0.CO;2-0