Background: Conflicting results from previous studies on gastric adenocarcinoma (GC) in young patients have led to controversy surrounding the prognosis for young GC patients. Methods: The authors studied 6954 patients with GC who received curative resections. They were classified into three groups: those aged 40 years or less ("young," 12.7%); those aged 41-65 years ("middle-aged," 66.7%); and those aged more than 65 years ("elderly," 20.6%). Clinicopathologic characteristics and overall survival rates were analyzed. Results: Young patients were predominately female and had tumors that were histologically undifferentiated. However, in regard to T4 invasion, N3 lymph node metastasis, and TNM stage IV, the characteristics of the tumors of young patients were similar to those of middle-aged and elderly patients. Overall survival rate was significantly better in young patients than middle-aged patients (P = .018) and elderly patients (P < .001). Stratified by TNM stage, young patients showed better overall survival at stage I than middle-aged patients, and at stages I, II, and IIIa than elderly patients. Multivariate analysis indicated that age was an independent prognostic factor (as well as gender, operation type, depth of invasion, and lymph node status). Conclusions: The predominance of female cases and tumors that were histologically undifferentiated were distinctive characteristics in young patients. Young patients could gain a survival benefit after curative resection with stage I disease.
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