Early-Onset Gastric Cancer Characteristics and Prognosis

Early-onset gastric cancer (EOGC), conventionally defined as gastric carcinoma diagnosed before the age of 45–50 years, has emerged as a distinct clinical and biological entity. Though overall incidence of gastric malignancy has declined in many regions, cases among young adults are rising globally. Patients often present with subtle or non-specific symptoms that overlap with benign conditions, leading to delayed diagnosis and a higher proportion of advanced-stage disease at presentation. Epidemiologically, there is a notable female predominance and a greater likelihood of diffuse-type histology, frequently associated with loss-of-function alterations in cell-adhesion genes such as CDH1. Tumours in younger patients tend to exhibit more aggressive behaviour, reflected by deeper invasion, higher rates of lymphovascular spread and poorer differentiation, yet overall survival may equal or exceed that of older cohorts when adjusted for stage. Prognostic determinants include tumour location within the stomach, depth of invasion, nodal status and serum biomarkers (for example CA125). The unique molecular landscape—often characterised by genomically stable or microsatellite-stable/epithelial–mesenchymal transition subtypes—suggests that conventional screening and treatment paradigms warrant adaptation. Advances in risk stratification, early detection strategies and tailored therapeutics are central to improving outcomes in this younger demographic.

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Early-Onset Gastric Cancer Characteristics and Prognosis publication trend

The graph below shows the total number of articles in early-onset gastric cancer characteristics and prognosis across all publications each year (not limited to Nature Index journals).

Technical terms

Genomically stable: Tumours lacking widespread copy-number alterations or microsatellite instability, often associated with diffuse histology.

Microsatellite instability (MSI): Genetic hypermutability caused by impaired DNA mismatch repair, leading to length variations in short tandem repeats.

Epithelial–mesenchymal transition (EMT): A biological process by which epithelial cells acquire migratory and invasive properties typical of mesenchymal cells.

Nomogram: A graphical tool that integrates multiple prognostic variables to estimate the probability of a clinical event, such as survival.

Cancer-specific survival (CSS): The proportion of patients who have not died from their cancer within a specified time frame, excluding other causes of death.

References

1. Early-Onset Gastrointestinal Malignancies: An Investigation into a Rising Concern. Cancers (2024).
2. Gastric Cancer in Young Adults: A Different Clinical Entity from Carcinogenesis to Prognosis. Gastroenterology Research and Practice (2020).
3. Multi‑institutional development and validation of a nomogram to predict prognosis of early-onset gastric cancer patients. Frontiers in Immunology (2022).