Abstract

GOMEZ, Martín; OTERO, William  and  CAMINOS, Jorge Eduardo. Gastric cancer in young patients in Colombia. Rev Col Gastroenterol [online]. 2012, vol.27, n.3, pp.166-172. ISSN 0120-9957.

Gastric cancer is the leading cause of death among cancers in Colombia. Although its incidence has fallen among older people throughout the world, in recent years it has been increasing among patients under 40 years old. Poor prognoses for these patients is due in part to late diagnoses and in part to the aggresivity of the disease. For these reasons the objectives of this study were to evaluate clinical, endoscopic and histological factors in gastric cancer patients under 40 years of age and compare those factors with findings from older patients in order to establish differences which might allow characterization of this group of patients. Materials and Methods. This is a retrospective, descriptive study of patients diagnosed with adenocarcinoma in the Hospital el Tunal between December 2005 and December 2010. During this period cancer patients under 40 years of age were compared with those over 40 years of age. Information collected on forms included patients' ages and sex and tumor, classification, type of and location. Of the 15,550 upper endoscopies performed during the study period, 226 patients were diagnosed with gastric adenocarcinoma and had their diagnoses confirmed histologically. 20 patients (8.8%) were under 40 years old and 206 were over 40 years old.  Results. The 20 patients under 40 years old were labeled Group 1 and the 206 patients who were over 40 years old were labeled Group II.  Average patient age in Group I was 33.5 years while average patient age in Group II was 63 years old. Patient age range in Group I was 17 to 40 years old while in Group 2 it was 41 to 95 years old. 45% of the patients in Group 1 were men while 61.7% of the patients in Group 2 were men (p:<0.05). 90% of the patients in Group I had diffuse adenocarcinomas while only 23.8%  (49) of the patients in Group II had diffuse adenocarcinomas (p:<0.05). Only one case was diagnosed early in Group I (5%) while 42 cases (20.4%) were diagnosed early in Group II (5%) (p:<0.05). Of the 19 advanced cases in Group I there were 5 cases of linitis plastica (26.3%) while there were 30 cases (14.5%) found in Group II (p:<0.05). Conclusion. Gastric cancer is slightly more prevalent among young patients in our study than the prevalence that has been reported elsewhere. These patients presented more advanced stages of cancer than did older patients, and the majority of their cancers were diffuse types (90%) which resulted in a high mortality rate. Early performance of endoscopy is mandatory for young patients. In addition preventative measures such as genetic studies for CDH1 carriers to protect family members from this terrible disease should also be mandatory.

Keywords : Gastric cancer; young patients; diffuse.

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