Severe Manifestations and Grave Prognosis in Young Patients with Gastric Cancer in Thailand

Background: Gastric cancer is the second leading cause of cancer death worldwide and occurs most frequently in the age group of 5070 years. Rarely reports have appeared regarding younger age groups. The purpose of this study was to compare clinical characteristics and outcome of treatment between young and elderly patients with gastric cancer in Thailand. Materials and Methods: Clinical information, histological features, endoscopic findings and treatment outcome were reviewed and collected from Thammasat University Hospital, Pathumthani and Bangkok Medical Center, Bangkok, Thailand between September 2011March 2015. Results: A total of 154 gastric tumor patients including 101 with benign tumors (22 males and 79 females, mean age 62.6 years) and 53 with gastric cancers (27 males and 26 females, mean age 60.6 years) were enrolled in this study. Gastric cancer patients presented with alarm symptoms such as anemia, anorexia and weight loss significantly more frequently than benign gastric tumor patients. In gastric cancer patients, mean duration of symptoms prior to diagnosis was shorter in younger (<40 years) than older patients (age 40 years) (73.3 days vs 84.8 days). Family history of GI malignancy and diffuse type of gastric cancer were significant greater in younger than older patients (36% vs 5% P0.01; OR 11.4, 95%CI 1.874.7 and 73% vs 14%, P<0.01; OR 16, 95%CI 3.378, respectively) and 5year survival rates were 9% in younger age patients and 19% in older age group. Conclusions: Most young patients with gastric cancer in Thailand feature aggressive manifestations with poorer prognosis than elderly patients. Early detection of gastric cancer in high risk young patients might be important key to improve survival rate and treatment outcome in this particular group.