Treatment outcomes in young adults with gastric cancer

Introduction . According to global data, gastric cancer (GC) is the 5-th most common malignancy with a high cancer-related mortality rate. However, in recent decades, there has been a tendency towards an increase in the incidence of GC among young patients (18 to 40 years old), which currently amounts to 4.4–9.8%. Aim : to evaluate the effectiveness of surgical, combined and palliative treatment options in early-onset GC. Material and Methods . the study included 129 patients aged 18–45 years, who underwent radical, cytoreductive and palliative surgery with or without combination with drug therapy for localized, locally-advanced and primary disseminated GC. the patients were divided into three clinical groups: 1) the surgical group (n=27) included patients with only surgical treatment; 2) the group of combined treatment (n= 58) included patients with PCI <7 who underwent surgery with the volume of CC0 in combination with CT (neoadjuvant, adjuvant, perioperative, simultaneously with or without hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) and patients who underwent only HIPEC; 3) the additional (palliative) group (n=44) included patients with PCI>7 who underwent systemic CT in combination with pressurized intraperitoneal aerosol chemotherapy (PIPAC). Results . the median overall survival (OS) in three groups was 58, 30 and 13 months, respectively. In patients with IV stage of disease who underwent HIPEC with CC0 surgery, OS in the 2nd group was 17 in comparison with 13 months in the third group (PIPEC). Conclusion . Aggressive multimodal treatment in the absence of comorbid status in young patients will allow for intensification of both the perioperative drug therapy component and the implementation of extended multivisceral resections that facilitate radical surgical treatment to improve both DFS and OS.