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Clinical characteristics and oncological outcomes of surgically treated early-onset gastric adenocarcinoma - a retrospective cohort study

Introduction: The incidence of early-onset gastric adenocarcinoma (patients <50 years, EOGA) is rising. Tumors in younger patients are associated with prognostically unfavorable features. The impact of EOGA on patient survival, however, remains unclear. The aim of this study is to evaluate early-...

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Main Authors: Rompen, Ingmar F. (Author) , Nienhüser, Henrik (Author) , Crnovrsanin, Nerma (Author) , Musa, Julian (Author) , Haag, Georg Martin (Author) , Longerich, Thomas (Author) , Fiedler, Timon (Author) , Müller, Beat P. (Author) , Peters, Leila (Author) , Billeter, Adrian (Author)
Format: Article (Journal)
Language:English
Published: 2023
In: Journal of cancer
Year: 2023, Volume: 14, Issue: 9, Pages: 1470-1478
ISSN:1837-9664
DOI:10.7150/jca.82876
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.7150/jca.82876
Verlag, lizenzpflichtig, Volltext: https://www.jcancer.org/v14p1470.htm
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Author Notes:Ingmar F. Rompen, Henrik Nienhüser, Nerma Crnovrsanin, Julian Musa, Georg Martin Haag, Thomas Longerich, Timon Fiedler, Beat P. Müller-Stich, Leila Sisic, Adrian T. Billeter
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Summary:Introduction: The incidence of early-onset gastric adenocarcinoma (patients <50 years, EOGA) is rising. Tumors in younger patients are associated with prognostically unfavorable features. The impact of EOGA on patient survival, however, remains unclear. The aim of this study is to evaluate early-onset age as a prognostic factor compared to late-onset gastric adenocarcinoma (LOGA, >50years) in a surgical cohort and assesstreatment options. Methods: We analyzed 738 patients (129 early-onset/609 late-onset) operated in curative intent from 2002 to 2021. Data was extracted from a prospectively managed database of an academic tertiary referral hospital. Differences in perioperative as well as oncological outcomes were calculated by chi-square test. Cox regression analysis was performed to assess disease-free survival (DFS) and overall survival (OS). Results: EOGA patients were more often treated with neoadjuvant therapy (62.8% vs. 43.7%, p<0.001) and extended surgical resections e.g. through additional resections (36.4% vs. 26.8%, p=0.027). EOGA was more often metastasized into regional lymph nodes (pN+ 67.4% vs. 55.3%, p=0.012) and to distant sites (pM+: 23.3% vs. 12.0%, p=0.001) and was more often poorly differentiated (G3/G4: 91.1% vs. 67.2%, p<0.001). There were no significant differences in overall complication rates (31.0% vs. 36.6%, p=0.227). Survival analysis showed shorter DFS (median DFS 25.6 months vs. not reached, p=0.006) but similar OS (median OS: 50.5 months vs. not reached, p=0.920) in EOGA compared to LOGA. Conclusions: This analysis confirmed that EOGA is associated with more aggressive tumor characteristics. Early-Onset was not a prognostic factor in the multivariate analysis. EOGA patients may be more capable to undergo intensive multimodal therapy including perioperative chemotherapy and extended surgery.
Item Description:Veröffentlicht: 21.5.2023
Gesehen am 28.09.2023
Physical Description:Online Resource
ISSN:1837-9664
DOI:10.7150/jca.82876

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