Gastric adenocarcinoma in young patients

Aims Gastric adenocarcinoma is among the leading causes of cancer-related deaths worldwide. While it predominantly affects the elderly, its occurrence in young individuals is rare and often associated with a poor prognosis. The objective of this study is to examine the epidemiological, clinico-pathological, therapeutic, and prognostic characteristics of gastric adenocarcinoma in young patients

Methods We conducted a retrospective study at Ibn Rochd University Hospital in Casablanca, from January 2021 to July 2024, including all young patients (aged<40 years) hospitalized for gastric adenocarcinoma in the oncology center at Ibn Rochd University Hospital. Data on demographics, clinical presentations, endoscopic findings, histopathological characteristics, therapeutic interventions, and outcomes were collected.Using Excel 2024 and Jamovi 2.2.5

Results During the study period, 470 patients were diagnosed with gastric adenocarcinoma, of which 34 (7.2%) were under 40 years of age. The median age of these young patients was 36 years (range: 20-40 years). There was a male predominance (61.8%, n=21) with a male-to-female ratio of 1.6. Active smoking was noted in 5 patients (14.7%), and a family history of gastric cancer in 6 patients (18%). The mean duration from symptom onset to diagnosis was 6 months. Clinically, 24 patients (70.6%) reported epigastric pain, 10 (30%) experienced vomiting, and 4 (12%) had upper GI hemorrhage. Fifteen patients (44%) presented with a deterioration of their general condition. Endoscopic examination revealed ulcerating and fungating tumors in 25 patients (73%), predominantly located in the pyloric antrum (35%), greater curvature (32%), gastric body (15%), and cardia (12%). Histologically, tumors were well-differentiated in 1 patient (5%), moderately differentiated in 5 patients (15%), and poorly differentiated in 22 patients (65%), with signet-ring cell morphology in 16 patients (47%). At diagnosis, 28 patients (82%) had metastatic disease, with peritoneal carcinomatosis being the most common site (65%). Curative surgery was possible in only 7 patients (26%), while palliative surgery was performed in 3 patients with hemorrhagic tumors.

Conclusions Our study sheds light on the challenge posed by gastric adenocarcinoma in young patients, typically considered low-risk. High rates of advanced-stage diagnosis (82% metastatic disease), predominantly poorly differentiated tumors (65%), and significant signet-ring cell morphology (47%) emphasize aggressive pathology. Despite its rarity (7.2% under 40 years), poor prognosis and limited curative options (26% curative surgery) underscore underscores the urgency for heightened vigilance and innovative diagnostic strategies in this population

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025