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. 1999 Jan;75(879):22–26. doi: 10.1136/pgmj.75.879.22

Outcome of oesophagogastric carcinoma in young patients

D Bowrey 1, G Clark 1, B Rees 1, G Williams 1, P Carey 1
PMCID: PMC1741100  PMID: 10396582

Abstract

The survival of young patients (⩽ 50 years of age) with carcinoma of the oesophagus or stomach has been reported to be poorer than that of their older counterparts. The aim of the current study was to review the outcome of such young patients with oesophagogastric cancer and to compare the outcome in patients with carcinoma of the oesophagus/cardia with patients with carcinoma of the more distal stomach. The study population was 50 patients. Tumour location was oesophagus/cardia (n=33) and gastric body/antrum (n=17). The most common presenting symptoms were weight loss (66%), epigastric pain (54%), dysphagia (50%), and heartburn (40%). Seventeen patients had experienced foregut symptoms for a period of ⩾6 months. These patients were more likely to have symptoms of gastro-oesophageal reflux disease and to have received acid suppression therapy than patients with shorter symptom durations. Only 20 patients underwent a potentially curative resection, while 10 underwent open and close laparotomy. The overall median survival was 7 months and the 5-year survival was 8%. Multivariate analysis revealed that surgical resection and UICC stage were the only factors that significantly influenced survival. There was no difference in the survival of patients with proximally situated tumours compared to those with distally located tumours. Wide variations in clinical practice were seen between different surgeons. Consequently, a multidisciplinary team designed to manage all patients with oesophagogastric cancer according to nationally agreed protocols has been established in our hospital. Earlier diagnosis of these tumours is to be encouraged, even if this necessitates the more liberal use of endoscopy in the evaluation of young patients with persistent foregut symptoms.


Keywords: oesophagus; stomach; carcinoma; surgery; age-factors

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Selected References

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  1. Adam D. J., Craig S. R., Sang C. T., Walker W. S., Cameron E. W. Oesophagogastrectomy for carcinoma in patients under 50 years of age. J R Coll Surg Edinb. 1996 Dec;41(6):371–373. [PubMed] [Google Scholar]
  2. Badwe R. A., Patil P. K., Bhansali M. S., Mistry R. C., Juvekar R. R., Desai P. B. Impact of age and sex on survival after curative resection for carcinoma of the esophagus. Cancer. 1994 Nov 1;74(9):2425–2429. doi: 10.1002/1097-0142(19941101)74:9<2425::aid-cncr2820740906>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  3. Bedikian A. Y., Khankhanian N., Heilbrun L. K., Bodey G. P., Stroehlein J. R., Valdivieso M. Gastric carcinoma in young adults. South Med J. 1979 Jun;72(6):654–656. doi: 10.1097/00007611-197906000-00007. [DOI] [PubMed] [Google Scholar]
  4. Bloss R. S., Miller T. A., Copeland E. M., 3rd Carcinoma of the stomach in the young adult. Surg Gynecol Obstet. 1980 Jun;150(6):883–886. [PubMed] [Google Scholar]
  5. Blot W. J., Devesa S. S., Kneller R. W., Fraumeni J. F., Jr Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA. 1991 Mar 13;265(10):1287–1289. [PubMed] [Google Scholar]
  6. Clark G. W., Roy M. K., Corcoran B. A., Carey P. D. Carcinoma of the oesophagus: the time for a multidiciplinary approach? Surg Oncol. 1996 Aug;5(4):149–164. doi: 10.1016/s0960-7404(96)80038-7. [DOI] [PubMed] [Google Scholar]
  7. Esaki Y., Hirayama R., Hirokawa K. A comparison of patterns of metastasis in gastric cancer by histologic type and age. Cancer. 1990 May 1;65(9):2086–2090. doi: 10.1002/1097-0142(19900501)65:9<2086::aid-cncr2820650933>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  8. Grabiec J., Owen D. A. Carcinoma of the stomach in young persons. Cancer. 1985 Jul 15;56(2):388–396. doi: 10.1002/1097-0142(19850715)56:2<388::aid-cncr2820560231>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  9. Lu J. P., Xian M. S., Hayashi K. Morphologic features in esophageal squamous cell carcinoma of young adults in north China. Cancer. 1994 Jul 15;74(2):573–577. doi: 10.1002/1097-0142(19940715)74:2<573::aid-cncr2820740207>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  10. Maehara Y., Orita H., Moriguchi S., Emi Y., Haraguchi M., Sugimachi K. Lower survival rate for patients under 30 years of age and surgically treated for gastric carcinoma. Br J Cancer. 1991 Jun;63(6):1015–1017. doi: 10.1038/bjc.1991.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Maehara Y., Watanabe A., Kakeji Y., Emi Y., Moriguchi S., Anai H., Sugimachi K. Prognosis for surgically treated gastric cancer patients is poorer for women than men in all patients under age 50. Br J Cancer. 1992 Mar;65(3):417–420. doi: 10.1038/bjc.1992.85. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Matley P. J., Dent D. M., Madden M. V., Price S. K. Gastric carcinoma in young adults. Ann Surg. 1988 Nov;208(5):593–596. doi: 10.1097/00000658-198811000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Mitsudomi T., Matsusaka T., Wakasugi K., Takenaka M., Kume K., Fujinaga Y., Teraoka H., Iwashita A. A clinicopathological study of gastric cancer with special reference to age of the patients: an analysis of 1,630 cases. World J Surg. 1989 Mar-Apr;13(2):225–231. doi: 10.1007/BF01658407. [DOI] [PubMed] [Google Scholar]
  14. Mori M., Ohno S., Tsutsui S., Matsuura H., Kuwano H., Sugimachi K. Esophageal carcinoma in young patients. Ann Thorac Surg. 1990 Feb;49(2):284–286. doi: 10.1016/0003-4975(90)90152-v. [DOI] [PubMed] [Google Scholar]
  15. Moriguchi S., Maehara Y., Korenaga D., Sugimachi K., Nose Y. Relationship between age and the time of surgery and prognosis after gastrectomy for gastric cancer. J Surg Oncol. 1993 Feb;52(2):119–123. doi: 10.1002/jso.2930520213. [DOI] [PubMed] [Google Scholar]
  16. Powell J., McConkey C. C. Increasing incidence of adenocarcinoma of the gastric cardia and adjacent sites. Br J Cancer. 1990 Sep;62(3):440–443. doi: 10.1038/bjc.1990.314. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Silcock J. G., Bramble M. G. Open access gastroscopy: second survey of current practice in the United Kingdom. Gut. 1997 Feb;40(2):192–195. doi: 10.1136/gut.40.2.192. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Tso P. L., Bringaze W. L., 3rd, Dauterive A. H., Correa P., Cohn I., Jr Gastric carcinoma in the young. Cancer. 1987 Apr 1;59(7):1362–1365. doi: 10.1002/1097-0142(19870401)59:7<1362::aid-cncr2820590722>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]

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