Analysis Of Clinical Features And Prognostic Factors Of Gastric Cancer In Young Patients

Objective We contrasted gerontal patient with gastric cancer to inquiry the clinical symptoms of youngsters,and probe into the relevant factors affecting their prognosis.MethodsWe gather gastric cancer cases admitted to our medical center from January 2013 to December 2017,and screen out 94 young patients(age ≤40 years old)treated by radical gastric cancer treatment as the observation group,matched by propensity score The method(propensity score-matched,PSM)screened out 94 cases from middle-aged and elderly patients(age>40 years old)and used them as the control group.By comparing the gender distribution,CCI score,initial symptoms,tumor family history,tumor location,maximum tumor diameter,pathological stage,pathological type,tumor markers to inquire into the clinical features of gastric cancer in youngsters.Follow-up of patients through outpatient clinics,phone messages,etc.,to inquire into the factors concern with the prognosis of young gastric cancer.Results1.General information: In our study,94 young gastric cancer patients are incorporated,there are 39 males and 55 females,ranging in age from 18 to 40 years old,with a median age of 35 years.Patients with low CCI score and women accounted for more in the young group(P < 0.001);There are more young patients with upper abdominal pain and discomfort as the first symptom than middle-aged and elderly patients,and less choking on eating,the difference is statistically significant(P=0.042).The incidence of proximal gastric tumors in the corresponding youth group is much lower than that of the elderly group(P= 0.001).In addition,the proportion of poorly differentiated tumors in the youth group was relatively high(P = 0.008).2.The median survival time of the young group and the old group was 26.5 months and27.5 months,respectively.The 1-,3-and 5-year survival rates of the two groups were69.1%,58.5%,41.3% and 70.2%,59.5%,45.8%,respectively.Youth in patients with senile patients of cumulative survival rate have no significant difference(P > 0.05),the same stage(Ⅰ-Ⅲ period)of the survival rates of two groups of patients with no significant difference(P > 0.05).3.The results of univariate analysis showed that the prognostic factors of young gastric cancer included tumor location,tumor’s largest diameter,depth of tumor invasion,extent of lymph node involvement,TNM stage,gross classification,CEA,AFP,CA125 and CA19-9.Multivariate analysis showed that the independent adverse prognostic factors included CA125 positive(HR:3.876,95%CI:1.518-9.896)and advanced gastric cancer(HR:11.909,95%CI:2.844-49.861).ConclusionsIn the case of matching baseline characteristics,compared with elderly patients,women and patients with low CCI scores accounted for more in the young group,low incidence of cardiac tumors,and low tumor differentiation;the cumulative survival rate of young patients and elderly patients is not significant difference;Advanced gastric cancer and CA125 positive are independent risk factors for the prognosis of young gastric cancer.