Early onset of gastric cancer in Egyptian patients: Is it really a different clinical entity?

Background: Little is known about characteristics of young patients with gastric carcinoma (GC) in Egypt. Aim: The purpose of this study was to define the clinicopathological features and survival of young GC patients in our population. Patients and Methods: We retrospectively analyzed data of 197 GC patients who were treated at our institution from 2011 to 2016. The clinicopathological characteristics and survival were compared between 61 young (≤45 years) and 136 older (>45 years) GC patients. We also studied variables impacting survival of younger patients. Results: The proportion of females, positive family history, and poorly differentiated tumors were significantly higher in young patients. Younger group showed significantly longer interval between symptoms and diagnosis (all P < 0.05). The mean overall survival (OS) of young patients was lower compared to older patients (10.7 vs. 18.7 months, respectively; P=0.06). Multivariate analyses revealed that distant metastasis and CA19-9 were independent factors for reduced survival in younger patients. Conclusion: We conclude that clinico-pathological characteristics of GC are different between young and old patients. Aggressive tumor biology and a significant diagnostic delay may have contributed to worse survival in younger patients.