Gastric Cancer Rates Have Increased in Younger Latin Women in Past Decade

Barcelona, Spain—Rates of gastric cancer have increased in the past decade more for women than men and for people aged ≤40 years than for those over 40 years, according to data being presented at the ESMO 21st World Congress on Gastrointestinal Cancer.

“Gastric cancer…has been considered a disease of the older population worldwide. In the last decade, GC [gastric cancer] has increased in the younger (≤40 years) population up to 15%, with a higher incidence in women,” explained lead investigator Germán Calderillo-Ruiz, MD, National Cancer Institute, Tlalpan, Mexico, and colleagues.

“These patients remain asymptomatic with late diagnosis and poor prognostic factors such as type and histological grade,” they continued.

 Seeking to describe the prevalence and prognostic factors, as well as the relationship between said frequency and factors and overall survival (OS), in Latin patients with gastric cancer treated at The National Cancer Institute in Mexico, Dr Calderillo-Ruiz et al carried out a retrospective, observational study.

A total of 2022 patients with gastric cancer, 290 of whom were aged ≤40 years, were included in the analysis, which took place between 2004 and 2016. To calculate OS and factor analysis between the groups with P <.05 bilateral statistical significance the investigators measured central tendency, and used the Kaplan-Meier, log-rank, and Cox regression model.

In the past 12 years, there has been a documented 120% increase in young patients with gastric cancer, with primary tumor being gastric (93%) and of the esophagogastric junction (7%).

According to histological data, 70% of patients had diffuse-type disease, 72% had cells-ring-seal, and 87% were poorly differentiated. Patients were classified as clinical stage I-III via total or partial gastrectomy (8%); locally advanced (16%); and clinical stage IV via tomography and/or laparoscopy (76%).

All patients in the study were given conventional oncologic treatments with or without supportive therapy approved by the institutional management guidelines. Notably, women had more poor prognostic factors than men, including diffuse-type (68% vs 32%, respectively; P = .127), ring-seal cells (76% vs 69%; P = .049), poorly differentiated (89% vs 84%; P = .014), and higher prevalence of EC-IV (59% vs 41%; P = .011).

Findings from an OS analysis revealed a median of 7 versus 8 months for women and men, respectively (P = .30; hazard ratio [HR], 1.29; 95% CI, 1.05-1.65). The median OS for primary gastric tumors was 7 months versus 14 months for primary esophagogastric junction (P = .23; HR, 0.68; 95% CI, 1.05-2.688).

In addition, the investigators observed significant differences in median OS between clinical stages I-III, locally advanced, and IV with 33, 12, and 5 months, respectively (P = .001; HR, 2.28; 95% CI, 1.72-3.01).

In the Cox-Regression analysis, independent predictors of OS were maintained in gender (P = 0.038; HR 1.29; 95% CI, 1.01-1.65), primary tumor (P = 0.020; HR 1.68; 95% CI, 1.05-2.68), and clinical stage (P = 0.001; HR, 2.28; 95% CI, 1.72-3.01), diffuse-type, ring-seal-cells and little-differentiation show no statistical significance.

“The incidence of GC [gastric cancer] in the younger population has been increasing over the last 12 years, with a greater incidence in females, contrary to what is seen in patients over 40 years,” Dr Calderillo-Ruiz and colleagues said.

“Poor prognosis factors such as clinical-stage IV, diffuse-type adenocarcinoma, presence of ring-seal cells, and poor-differentiation are more frequent in young women, showing a decrease in OS,” they concluded.—Hina Khaliq

Calderillo-Ruiz G, Takahashi A, Herrera M, et al. Gastric cancer in young Latin women: bad prognostic factors and outcomes. Presented at: the ESMO 21st World Congress on Gastrointestinal Cancer; July 3-6, 2019; Barcelona, Spain. Abstract P-145.