Gastric cancer in the young: A real-world experience

Gastric cancer ranks as the fifth most prevalent malignancy worldwide. Although predominantly affecting individuals aged 50-70 years, a small proportion presents at a younger age, often displaying distinct biological behavior and adverse outcomes. We assessed the clinicopathological characteristics and outcomes of young patients with gastric cancer and compared them with those of older individuals.

A retrospective analysis of gastric cancer patients diagnosed between 2018 and 2022 at a tertiary cancer center compared younger (<45 years) and older (≥45 years) groups across demographic, pathological, treatment, and survival variables. Kaplan-Meier analysis assessed disease-free survival (DFS), progression-free survival (PFS), and overall survival (OS).

Among 296 patients, 147 (49.6%) were ≤45 years, with a median age of 40 years. Male predominance was less evident among younger patients (1.45:1 versus 3.65:1, P = 0.0003). Younger patients had more high-grade tumors ( P = 0.0018) and peritoneal metastases. The 3-year DFS and OS in young and older patients with localized disease were 32%, 38% and 33%, 38%, respectively ( P = 0.8338 and P = 0.7713, respectively). The 3-year PFS and OS of young and older patients with metastatic disease were 11%, 14% and 8%, 12%, respectively ( P = 0.5756 and P = 0.8072, respectively).

Nearly 40% of patients were below 45 years. Despite a higher prevalence of aggressive features and metastatic presentation, survival outcomes were similar across age groups when managed with comparable treatment protocols.