Aim. The aim of this study was to see the clinical, pathological, and demographic profile of young patients with stomach carcinoma besides association with p53. Patients and Methods. Prospective study of young patients with stomach carcinoma from January 2005 to December 2009. A total of 50 patients with age less than 40 years were studied. Results. Male female ratio was 1?:?1.08 in young patients and 2.5?:?1 in older patients. A positive family history of stomach cancer in the first degree relatives was present in 10% of young patients. Resection was possible only in 50% young patients. 26% young patients underwent only palliative gastrojejunostomy. The most common operation was lower partial gastrectomy in 68%. Amongst the intraoperative findings peritoneal metastasis was seen in 17.4% in young patients. 50% young patients presented in stage IV as per AJCC classification ( value .004; sig.). None of the patients presented as stage 1 disease in young group. Conclusion. Early detection of stomach carcinoma is very important in all patients but in young patients it is of paramount importance. 1. Introduction Gastric cancer is the second leading cause of death due to malignancy worldwide and occurs most frequently in the age group of 50–70 years [1–3]. However, over the past half century several studies have reported on the clinical and pathological features of gastric carcinoma in young adults in the range of 2%–8% in different series [4]. The incidence of gastric cancer is the highest in Japan, China, south America and eastern Europe and the lowest in the United States [2]. Gastric cancer is the third most common cancer in Kashmir only superseded by esophageal and lung cancer [5]. Considerable evidence suggests the role of genetic factors in the pathogenesis of gastric carcinoma. Clustering of this disease within families has been reported in Bonaparte’s family. Napoleon, his father, his grand father, and several of his siblings died of cancer stomach [2]. Inherited or familial gastric cancer and hereditary diffuse gastric cancer (HDGC) are common in patients younger than 40 years of age. Patients with hereditary nonpolyposis colorectal cancer (Lynch syndrome II) are at increased risk of stomach cancer. First degree relatives of patients with gastric cancer have a two- to threefold increased risk of developing this disease [6]. There is an increased risk of gastric cancer in people with blood group A [2]. Diets rich in salted, smoked, or poorly preserved foods are associated with increased risk of cancer stomach, whereas diets rich in fruits and
References
[1]
O. Llanos, J. M. Butte, F. Crovari, I. Duarte, and S. Guzmán, “Survival of young patients after gastrectomy for gastric cancer,” World Journal of Surgery, vol. 30, no. 1, pp. 17–20, 2006.
[2]
C. S. Fuchs and R. J. Mayer, “Medical progress: gastric carcinoma,” New England Journal of Medicine, vol. 333, no. 1, pp. 32–41, 1995.
[3]
C. P. Theuer, C. De Virgilio, G. Keese et al., “Gastric adenocarcinoma in patients 40 years of age or younger,” American Journal of Surgery, vol. 172, no. 5, pp. 473–477, 1996.
[4]
M. S. Levine, I. Laufer, and J. J. Thompson, “Carcinoma of the gastric cardia in young people,” American Journal of Roentgenology, vol. 140, no. 1, pp. 69–72, 1983.
[5]
M. T. Rasool, M. M. Lone, M. L. Wani, F. Afroz, S. Zaffar, and M. Mohib-ul Haq, “Cancer in Kashmir, India: burden and pattern of disease,” Journal of Cancer Research and Therapeutics, vol. 8, no. 2, pp. 243–246, 2012.
[6]
D. W. Mercer and E. K. Robinson, Stomach. Sabiston's Text Book of Surgery, vol. 2, 17th edition.
[7]
N. J. Bellegie, C. David, and D. C. Dahlin, “Malignant disease of the stomach in young adults,” Annals of Surgery, vol. 138, no. 1, pp. 7–12, 1953.
[8]
T. J. Hall, J. Moulder, H. S. Hsu, J. Achord, and C. E. Scott-Conner, “Gastric carcinoma among younger individuals in Mississippi,” Southern Medical Journal, vol. 86, no. 3, pp. 302–304, 1993.
[9]
C. P. Theuer, T. Kurosaki, T. H. Taylor, et al., “Unique features of gastric carcinoma in the young,” Cancer, vol. 83, no. 1, pp. 25–33, 1998.
[10]
H. Katai, M. Sasako, T. Sano, and K. Maruyama, “Gastric carcinoma in young adults,” Japanese Journal of Clinical Oncology, vol. 26, no. 3, pp. 139–143, 1996.
[11]
R. Santoro, F. Carboni, P. Lepiane, G. M. Ettorre, and E. Santoro, “Clinicopathological features and prognosis of gastric cancer in young European adults,” British Journal of Surgery, vol. 94, no. 6, pp. 737–742, 2007.
[12]
P. L. Tso, W. L. Bringaze, A. H. Dauterive, et al., “Gastric carcinoma in the young,” Cancer, vol. 59, no. 7, pp. 1362–1365, 1987.
[13]
P. J. Matley, D. M. Dent, M. V. Madden, and S. K. Price, “Gastric carcinoma in young adults,” Annals of Surgery, vol. 208, no. 5, pp. 593–596, 1988.
[14]
A. Ramos-Dela Medina, N. Salgado-Nesme, G. Torres-Villalobos, and H. Medina-Franco, “Clinicopathologic characteristics of gastric cancer in a young patient population,” Journal of Gastrointestinal Surgery, vol. 8, no. 3, pp. 240–244, 2004.
[15]
K. Umeyama, M. Sowa, and K. Kamino, “Gastric carcinoma in young adults in Japan,” Anticancer Research, vol. 2, no. 5, pp. 283–286, 1982.
[16]
M. Mori, K. Sugimachi, and T. Ohiwa, “Early gastric carcinoma in Japanese patients under 30 years of age,” British Journal of Surgery, vol. 72, no. 4, pp. 289–291, 1985.
[17]
M. Rugge, P. Arslan, E. Egarter-Vigl et al., “The p53 gene in patients under the age of 40 with gastric cancer: mutation rates are low but are associated with a cardiac location,” Journal of Clinical Pathology, vol. 53, no. 4, pp. 207–210, 2000.
[18]
D. Tolbert, C. Fenoglio-Preiser, A. Noffsinger et al., “The relation of p53 gene mutations to gastric cancer subsite and phenotype,” Cancer Causes and Control, vol. 10, no. 3, pp. 227–231, 1999.
[19]
U. Hsieh, J. T. Hsieh, L. Y. Wang, C. Y. Fang, S. H. Chang, and T. Chen, “p53 mutations in gastric cancers from Taiwan,” Cancer Letters, vol. 100, no. 1-2, pp. 107–113, 1996.