More attention should be paid to adult gastric cancer patients younger than 35 years old: extremely poor prognosis was found
More attention should be paid to adult gastric cancer patients younger than 35 years old: extremely poor prognosis was found
复制标题
35岁以下成人胃癌患者应更多关注：发现预后极差
DOI：
10.7150/jca.27517
复制
发表时间：
2019-01-01
影响因子：
3.9
通讯作者：
Qiu, Miao-Zhen
中科院分区：
文献类型：
--
作者：
Guan, Wen-Long;Yuan, Lu-Ping;Qiu, Miao-Zhen
目的：一些研究报道了关于年轻胃癌患者预后的有争议的结果。这种差异可能部分是由于对年轻人的定义不同造成的。本研究旨在探讨年龄与胃癌患者预后的关系，分析青年胃癌患者的临床病理特征及影响预后的因素。方法：本分析查询的数据包括1973年至2014年监测、流行病学和最终结果项目数据库中的GC患者。纳入了年龄≥18岁的胃癌患者（N= 79，505）。结合预后相似的患者，我们得出了3个年龄分界值，35岁，65岁和75岁。我们将患者分为4组：年轻患者：18-34岁;中年患者：35-64岁;老年患者：65-74岁;极老年患者：>74岁。来自中山大学肿瘤防治中心（SYSUCC）的GC患者用作外部验证数据。结果如下：青年人胃癌的临床病理特征包括：低分化、弥漫型和诊断时的晚期。<35岁患者的中位生存期显著低于中年患者（35-64岁）和老年患者（65-74岁）（分别为12个月vs. 15和16个月，均p <0.001）。多因素分析显示，肿瘤部位、种族、肿瘤大小、手术方式和TNM分期是影响青年患者预后的独立因素。在SYSUCC数据库中，年轻患者的不良预后仍然有效。结论：我们的结果表明，<35岁的胃癌患者预后极差。早期发现胃癌在年轻人中至关重要。
Purpose: Several studies have reported controversial results about prognosis of gastric cancer in young age patients. The difference may partially result from variable definitions of young age. The aim of this study was to find out the relation between age and prognosis of gastric cancer patients, and to analyze the clinicopathological features and prognostic factors in young gastric cancer patients. Methods: Data queried for this analysis included GC patients from the Surveillance, Epidemiology, and End Results Program database from 1973 to 2014. Gastric cancer patients (N=79,505) diagnosed with an age≥18 were included. By combining patients with similar prognosis, we figured out 3 cutoff values of age, 35 years old, 65 years old and 75 years old. We divided patients into 4 groups: young age patients: 18-34 years; middle-age patients: 35-64 years; elderly patients: 65-74 years; extremely elderly patients: >74 years. GC patients from Sun Yat-sen University Cancer Center (SYSUCC) were used as external validation data. Results: The clinicopathological features of young age gastric cancer patients included: poor-differentiated, diffuse type of cancer, and advanced stage at diagnosis. The median survival of patients <35 years old was significantly lower than middle-age patients (35-64 years) and elderly patients (65-74 years) (12 months vs. 15 and 16 months, respectively, both p <0.001). Location of tumor, ethnicity, tumor size, surgery and TNM stage were independent prognostic factors by multivariate analysis in young patients. The poor prognosis for young patients remained valid in the SYSUCC database. Conclusions: Our results demonstrated that gastric cancer patients <35 years old had an extremely poor prognosis. Early detection of gastric cancer is of paramount importance in young age people.