OBJECTIVETo investigate the clinicopathologic features and prognosis of gastric cancer in young patients (YGC) in order to improve the treatment outcome of YGC.

METHODSClinical data of 63 YGC patients (40 years of age and less) who underwent surgery from January 2004 to December 2006 were analyzed retrospectively. A total of 654 older gastric cancer patients (OGC, above 40 years) during the same period patients were selected and compared to the YGC patients.

RESULTSThe proportions of female patients, patients with a family history or with undifferentiated tumor in YGC were significantly higher than OGC (all P<0.05). The curative resection rate of YGC patients was 61.9% (39/63), significantly lower than that of OGC (93.1%, 595/654, P<0.01). A total of 653 (91.1%) patients were followed up, with a period of time of 1 to 84 months. The 5-year survival rates for YGC and OGC patients were 40.5% and 55.6% respectively, and the difference was statistically significant (P<0.05). Cox proportional hazards model showed that the depth of invasion, lymph node metastasis, and radical surgery were the independent factors associated with the prognosis of YGC (all P<0.05). The stratified analysis showed that the 5-year survival rates for YGC and OGC patients undergoing radical surgery were 63.2% and 56.7% respectively and the difference was not statistically significant (P>0.05). The 5-year survival rates for YGC and OGC patients undergoing palliative surgery were 4.2% and 22.2% respectively and the difference was statistically significan t(P<0.05).

CONCLUSIONGastric cancer in young patients is highly malignant, with lower rate of curative resection and poorer prognosis. The long-term outcome of YGC is similar to that of OGC if radical resection is possible.