Pediatric gastric adenocarcinoma: A National Cancer Data Base review.

Abstract:

PURPOSE:We sought to compare the presentation, management, and outcomes in gastric adenocarcinoma cancer for pediatric and adult patients. METHODS:Using the 2004 to 2014 National Cancer Database (NCDB), patients ≤21 years (pediatric) were retrospectively compared to >21 years (adult). Chi-squared tests were used to compare categorical variables, and Cox regression was used to estimate hazard ratios (HR) for survival differences. RESULTS:Of the 129,024 gastric adenocarcinoma cases identified, 129 (0.10%) occurred in pediatric patients. Pediatric cases presented with more advanced disease, including poorly differentiated tumors (81% vs 65%, p = 0.006) and stage 4 disease (56% vs 41%, p = 0.002). Signet ring adenocarcinoma comprised 45% of cases in the pediatric group as compared to 20% of cases in the adults (P < 0.001). Similar proportions in both groups underwent surgery. However, near-total gastrectomy was more common in the pediatric group (16% vs 6%, p < 0.001). The proportions of patients with negative margins, nodal examination, and presence of positive nodes were similar. There was no overall survival difference between the two age groups (HR 0.92, 95% Confidence interval 0.73-1.15). CONCLUSION:While gastric adenocarcinoma in pediatric patients present with a more advanced stage and poorly differentiated tumors compared to adults, survival appears to be comparable. TYPE OF STUDY:Retrospective cohort study. LEVEL OF EVIDENCE:III.

journal_name

J Pediatr Surg

authors

Tessler RA,Dellinger M,Richards MK,Goldin AB,Beierle EA,Doski JJ,Goldfarb M,Langer M,Nuchtern JG,Raval MV,Vasudevan S,Gow KW

doi

10.1016/j.jpedsurg.2019.01.048

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

1029-1034

issue

5

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(19)30085-5

journal_volume

54

pub_type

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