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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| Hauptverfasser: | , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2023
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| In: |
Journal of cancer
Year: 2023, Jahrgang: 14, Heft: 9, Pages: 1470-1478 |
| ISSN: | 1837-9664 |
| DOI: | 10.7150/jca.82876 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.7150/jca.82876 Verlag, lizenzpflichtig, Volltext: https://www.jcancer.org/v14p1470.htm 
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| Verfasserangaben: | 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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| 245 | 1 | 0 | |a Clinical characteristics and oncological outcomes of surgically treated early-onset gastric adenocarcinoma - a retrospective cohort study |c 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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| 520 | |a 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. | ||
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