| Objective To contrast the clinicopathologic characteristics and the factors influencing the prognosis of gastric cancer of young and elderly patients. To provided the theoretical evidence of the prevention and therapy for the gastric cancer. Methods 1439 patients with gastric cancer diagnosed by operation and pathology had been selected from January 1996 to December 2005. including 87 young cases(age≤35 years) and 365 elderly cases (age≥65 years). And to analyze the relation of gender,symptom,pathogenesis,location,clinicopathology,family history,therapy and the factors influencing the prognosis of gastric carcinoma between them Results (1)Gender: In the series of young patients, female predominated. Male predominated in the eldely group respectively. (2)symptom and pathogenesis: No statistically significant difference was observed in duration of symptoms between the both group: a mean of 9.31 and 8.30 months in the young and elderly group, respectively. The most common presenting symptoms were abdominal pain, followed by hematemesis,melena,hematochezia in young and dysphagia in elderly group. (3)The location of tumor: The young is least common in the carcinoma of gastric cardia than the elderly (25.28％and 39.53％, respectively); And there was significant difference in the statiatic between the two group. (4) Histologically: both were most common cases with poorly differentiated and muco-cellular adenocarcinama. The most common histological type was poorly differentiated and undifferentiated adenocarcinoma in young group than in the elderly group(poorly differentiated adenocarcinoma was 40.22％and 25.85％, respectively, undifferentiated adenocarcinoma was 20.69％and 10.90％, respectively). but least in the papillary and tubular adenocarcinama(papillary adenocarcinama was 2.30％and 10.90％, respectively, tubular adenocarcinama was 3.45％and 10.26％, respectively). Both has significant difference between them. (5)Clinic stage and distal metastases: most patients with known disease were classified as gross and clinic stageⅢand stageⅣ. The young was most common in the stageⅣthan the elderly, the difference was significant in statistic between them. The most common site about the distant metastases was peritoneum, followed by liver. (6) family history and comorbidity: there was more cases about the family history of tumor in the young group than the elderly group (13.79％and 2.99％, respectively), the difference was significant in the statistics. But the latter has more cases in the comorbidities than the former (12.61％and 0％, respectively), the difference was significant in ststistics, also. (7) The rate of curative resection: The rate of curative resection in young group was higher than the elderly group(64.32％and 47.12％, respectively). the difference was significant in the statistics. (8) The result of therapy: the median survival of the young and elderly group was 28 months and 33 months, respectively. The rate of the survival in the elderly group is higher than that of the young one, but the difference was no significant in the statistics, p=0.059. the prognosis of the young group in the carcinoma of gastric cardia was bad than the elderly one(17 months and 25 months, respectively), and the difference was significant in the statistics, the prognosis of the young group about the stageⅣwas bad than the elderly one(6 months and 9 months, respectively ), and the difference was significant in the statistics, also. Conclusions young group with gasteic cancer differ from Elderly group in gender, clinical manifestations, tumor location, pathological histology types , clinic stage, family history and other aspects. The overall survival of the young group is less than that of the elderly one(28 months and 33 months, respectively ). The most important reason of the bad prognosis of gastric cancer of the young group was the high incidences of the poorly differentiated and undifferentiated adenocarcinama, the high degree of malignancy, and also easy to metabasis, faster to advanced, including the delay of the clinic stage, the high incidence of stageⅣ, the lower rate of curative resection. if we could diagnose early, therapied in time and strive for the early curative resection. we could promote the curative effect of gastric cancer of young patients. |
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