Pediatric gastric adenocarcinoma: A National Cancer Data Base review

Area of Science:

• Oncology
• Pediatric Oncology
• Gastroenterology

Background:

• Gastric adenocarcinoma is rare in children, with limited data on its characteristics compared to adult cases.
• Understanding age-specific differences is crucial for optimizing diagnosis and treatment strategies.

Purpose of the Study:

• To compare the clinical presentation, management approaches, and patient outcomes for gastric adenocarcinoma between pediatric and adult populations.
• To identify any significant differences in disease stage, tumor characteristics, and treatment modalities between the two groups.

Main Methods:

• A retrospective analysis of the National Cancer Database (NCDB) from 2004 to 2014.
• Comparison of patients aged ≤21 years (pediatric) with those aged >21 years (adult) using chi-squared tests and Cox regression for survival analysis.

Main Results:

• Pediatric gastric adenocarcinoma cases (0.10%) presented with more advanced disease, including poorly differentiated tumors (81% vs 65%) and stage 4 disease (56% vs 41%).
• Signet ring cell histology was more prevalent in pediatric patients (45% vs 20%).
• Despite differences in presentation, overall survival was comparable between pediatric and adult patients (HR 0.92).

Conclusions:

• Gastric adenocarcinoma in pediatric patients is characterized by more advanced stage at diagnosis and distinct histological subtypes compared to adults.
• Treatment and outcomes, including overall survival, appear similar between pediatric and adult patients despite initial presentation differences.