Clinicopathologic Characteristics of Young Gastric Cancer Patients: Diagnostic Staging Accuracy and Survival

PURPOSE: The purpose of this study was to investigate the clinicopathologic characteristics of young gastric cancer patients and analyze the risk factors for stage underestimation and survival. METHODS: Relevant data of 5029 patients who underwent surgery for gastric cancer at Seoul National University Bundang Hospital between 2003 to 2014 were collected. Patients were divided based on age (younger group and older group). Clinical stages were compared to pathologic stages for accuracy, and risk factors for underestimation were analyzed using univariate and multivariate analysis regression. Overall survival and cancer-specific survival were analyzed using the Kaplan-Meier method. RESULTS: A total of 4396 patients were eligible for inclusion. The younger group was an independent risk factor for nodal metastasis (RR=1.44, 95% CI 1.06~1.95) and an independent risk factor for clinical N-stage underestimation (RR=1.50, 95% CI=1.14~1.98). However, there was no significant difference in 5-year cancer-specific survival for both age groups (92.2% vs 90.2%, p=0.306). CONCLUSION: In conclusion, intra-operative investigation of T-stage with standard operation should be done in young gastric cancer patients as they have a higher incidence of lymph node metastasis, with greater frequency of stage underestimation.