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2006 Abstracts: Gastric adenocarcinoma: clinico-pathological characteristics in young patients
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Gastric adenocarcinoma: clinico-pathological characteristics in young patients
carlos e. jacob, Claudio J. Bresciani, Bruno Zilberstein, Rodrigo Perez, Rafael Santos, Igor Proscurshim, Joaquim Gama-Rodrigues; Gastroenterology, University of Sao Paulo, Sao Paulo, Brazil

Gastric cancer is a leading cause of death in the world. In Brazil , this disease is the most frequent gastrointestinal cancer and occurs mainly in elderly people. Prognosis of gastric cancer in young patient is a subject of of debate The aim of this study was to analyze clinicopathologic characteristics of young patients with gastric adenocarcinoma. We analysed the gastric cancer database of University of São Paulo School of Medicine (Hospital das Clinicas). The period of the study is from January 1, 1971 to December 31, 2004. A retrospective review of charts from patients 45 years or younger with a diagnosis of gastric adenocarcinoma was done. We found 2217 patients with gastric adenocarcinoma. Of these population, 263 (11.9%)were 45 years of age or younger (range 14 to 45). The mean age of diagnosis was 39 yeras. There were 154 male (58.6%)and 109 female (ratio 1.4: 1). The mean time of symptoms was 8 months (range 0 to 45) and the main complaint was epigastric pain. Family history of gastric cancer was observed in only 8 patients (3%). Resection was possible in 180 patients (68.4%), but radical intention (D2 lymphadenectomy) was performed in 125 cases (47.5% of all patients). Twenty-three patients had resection of others organs due to radical lymphadenectomy or direct invasion. Subtotal gastrectomy was performed in the majority of patients (63%). Complications were observed in 21 patients submitted to D2 lymphadenectomy (16.8%). The mortality rate of this group was 2.4%. Half of the patients had a tumor located at distal third. The majority od the cases were Diffuse Lauren`s type. Early gastric cancer were observed in 15 % of this population. Lymph node metastasis were found in 50 % of patients submitted to radical operation. Advanced stage (III and IV AJCC staging)were observed in half of this population. Follow-up ranges from 12 to 288 months. Recurrence ocurred in 31% (39 patients), mainly in advanced cases. In spite some diferences in clinico-pathological characteristics when compared to general population, young patients with gastric adenocarcinoma could be treated with D2 lymphadenectomy with similar survival rates.


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