[Stomach cancer in patients under 40]

Fifty-one patients below the age of forty were treated for stomach carcinoma at the Surgical Hospital of Mainz University, between 1970 and 1986. They accounted for 5.2 per cent of all patients with stomach carcinoma. Diagnosis had been delayed under the following characteristic circumstances: The interval between onset of symptoms and diagnosis had been more than a year in 34 per cent of all cases. Fifty per cent of the patients had been originally hospitalised, following false suspicious diagnosis. Primary examination for gastro-intestinal passage produced falsely negative results in 43 per cent. The same falsely negative outcome was recorded from 24 per cent, following gastroscopy, and from twelve per cent, following gastroscopy combined with tissue sampling. The percentage of early stomach carcinomas was twice as high as that recorded from patients over forty. Undifferentiated carcinomas, on the other hand, were predominant in patients below forty, whereas adenocarcinomas were primarily recorded from patients over forty. Curative resection was successful in 55 per cent of the over-forties and 44 per cent of the under-forties. No-recurrence intervals were longer among the over-forties. However, five-year survival rates in Stages I, II, and III were better among the under-forties. Hence, the conclusion has been drawn from these findings that stomach carcinoma prognosis of patients below forty is better than that in higher age groups. This, however, is contradictory to other investigations reported in the literature.