Clinicopathological comparison of gastric cancer in young (<45 years) versus elderly (>60 years) patients: a single-center retrospective study.
- 1Endoscopy Center, Peking University People's Hospital, Beijing, China.
- 2Department of Geriatric Medicine, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
Abstract
Gastric cancer exhibits distinct clinicopathological features across different age groups, yet systematic comparisons in large contemporary Chinese cohorts remain limited. This study aimed to compare the clinicopathological profiles of young (<45 years) and elderly (>60 years) patients. This retrospective cross-sectional analysis evaluated 428 patients diagnosed with gastric cancer via gastroscopy and pathology at Peking University People's Hospital from October 2015 to October 2025. Patients aged <45 years were assigned to the young group (n=43) and those aged >60 years were assigned to the elderly group (n=385). Clinicopathological characteristics, World Health Organization (WHO) histological subtypes, H. pylori infection status, and clinical symptoms were compared between the two groups. The young group had significantly higher proportions of female patients (48.8% vs. 26.5%, P=0.002) and those with a family history of gastric cancer (14.0% vs. 3.6%, P=0.01), but a lower smoking rate (11.6% vs. 28.1%, P=0.02). Tumors in young patients were more frequently located in the antrum (58.1% vs. 34.5%, P=0.001), whereas fundus/cardia involvement was more common in elderly patients (39.2% vs. 9.3%, P<0.001). Borrmann type IV was more prevalent in the young group (35.7% vs. 19.2%, P=0.01), and Borrmann type I was more prevalent in the elderly group (4.8% vs. 17.6%, P=0.03). The proportion of poorly differentiated tumors was significantly greater in the young group (95.3% vs. 49.9%, P<0.001), with signet ring cell carcinoma being notably more frequent (30.2% vs. 5.5%, P<0.001). Younger patients also had a higher rate of H. pylori infection (79.1% vs. 61.8%, P=0.03) and a higher proportion of stage IV disease (41.9% vs. 25.7%, P=0.03). Compared with elderly patients, young patients with gastric cancer present with more aggressive tumor features, distinct tumor locations (antrum predominance), and higher H. pylori infection rates. These findings suggest that young patients may benefit from more aggressive surveillance and tailored endoscopic strategies.
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BibTeX
@article{zhang2026clinicopathological,
title = {{Clinicopathological comparison of gastric cancer in young (<45 years) versus elderly (>60 years) patients: a single-center retrospective study.}},
author = {Junxuan Zhang and Rui Zhao and Qingshan Bai and Qiyue Zhang and Liming Zhang},
journal = {Journal of gastrointestinal oncology},
year = {2026},
month = aug,
doi = {10.21037/jgo-2026-0498},
url = {https://europepmc.org/article/MED/42996846},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Clinicopathological comparison of gastric cancer in young (<45 years) versus elderly (>60 years) patients: a single-center retrospective study.
AU - Junxuan Zhang
AU - Rui Zhao
AU - Qingshan Bai
AU - Qiyue Zhang
AU - Liming Zhang
PY - 2026
DA - 2026/08/24
JO - Journal of gastrointestinal oncology
DO - 10.21037/jgo-2026-0498
UR - https://europepmc.org/article/MED/42996846
AB - Gastric cancer exhibits distinct clinicopathological features across different age groups, yet systematic comparisons in large contemporary Chinese cohorts remain limited. This study aimed to compare the clinicopathological profiles of young (<45 years) and elderly (>60 years) patients. This retrospective cross-sectional analysis evaluated 428 patients diagnosed with gastric cancer via gastroscopy and pathology at Peking University People's Hospital from October 2015 to October 2025. Patients aged <45 years were assigned to the young group (n=43) and those aged >60 years were assigned to the elderly group (n=385). Clinicopathological characteristics, World Health Organization (WHO) histological subtypes, H. pylori infection status, and clinical symptoms were compared between the two groups. The young group had significantly higher proportions of female patients (48.8% vs. 26.5%, P=0.002) and those with a family history of gastric cancer (14.0% vs. 3.6%, P=0.01), but a lower smoking rate (11.6% vs. 28.1%, P=0.02). Tumors in young patients were more frequently located in the antrum (58.1% vs. 34.5%, P=0.001), whereas fundus/cardia involvement was more common in elderly patients (39.2% vs. 9.3%, P<0.001). Borrmann type IV was more prevalent in the young group (35.7% vs. 19.2%, P=0.01), and Borrmann type I was more prevalent in the elderly group (4.8% vs. 17.6%, P=0.03). The proportion of poorly differentiated tumors was significantly greater in the young group (95.3% vs. 49.9%, P<0.001), with signet ring cell carcinoma being notably more frequent (30.2% vs. 5.5%, P<0.001). Younger patients also had a higher rate of H. pylori infection (79.1% vs. 61.8%, P=0.03) and a higher proportion of stage IV disease (41.9% vs. 25.7%, P=0.03). Compared with elderly patients, young patients with gastric cancer present with more aggressive tumor features, distinct tumor locations (antrum predominance), and higher H. pylori infection rates. These findings suggest that young patients may benefit from more aggressive surveillance and tailored endoscopic strategies.
SN - 2078-6891
SN - 2219-679X
ER -