Department of Gastroenterology, Second Affiliated Hospital of Baotou Medical College, Baotou, 014000, China , nianyuanyuannina@163.com
Abstract: (11 Views)
Background:This study examines the clinicopathological characteristics, recurrence patterns, and survival outcomes of early-onset gastric cancer (EOGC) patients treated with radiotherapy, comparing them with non-early-onset gastric cancer (NEOGC) patients to evaluate prognostic differences and the effectiveness of radiotherapy-based treatments. Materials and Methods: A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015), analyzing 814 EOGC and 4,997 NEOGC patients who underwent radiotherapy. Descriptive statistics characterized clinical and pathological features. Kaplan-Meier survival analysis and log-rank tests compared overall survival (OS). Cox proportional hazards regression models identified independent prognostic factors. Results: EOGC patients showed a higher proportion of females (42.3%) and advanced-stage disease (44.3%) compared to NEOGC. Signet-ring cell carcinoma was more prevalent in EOGC (26.8% vs. 14.7%, P < 0.001). Tumors in EOGC were predominantly located in the gastric body, fundus, and greater curvature (P < 0.001). Adjuvant radiotherapy was more common in EOGC (78.9% vs. 68.3%, P < 0.001). Survival analysis indicated that radiotherapy alone provided superior OS compared to combined chemoradiotherapy or surgery-radiotherapy approaches. Cox regression identified tumor stage, histological subtype, and radiotherapy modality as key prognostic factors. Conclusion: EOGC treated with radiotherapy exhibits distinct clinicopathological features, including more aggressive histological subtypes. Radiotherapy as monotherapy offers better long-term survival than multimodal treatments. These findings underscore the need for personalized radiotherapy strategies to optimize prognosis in EOGC.