TY - JOUR
T1 - Pediatric gastric adenocarcinoma
T2 - A National Cancer Data Base review
AU - Tessler, Robert A.
AU - Dellinger, Matthew
AU - Richards, Morgan K.
AU - Goldin, Adam B.
AU - Beierle, Elizabeth A.
AU - Doski, John J.
AU - Goldfarb, Melanie
AU - Langer, Monica
AU - Nuchtern, Jed G.
AU - Raval, Mehul V
AU - Vasudevan, Sanjeev
AU - Gow, Kenneth W.
N1 - Funding Information:
Funding: Dr. Tessler was supported by grant 5 T32 HD057822 from National Institute of Child Health and Human Development .
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/5
Y1 - 2019/5
N2 - 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
AB - 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
KW - Pediatric gastric adenocarcinoma
KW - Pediatric gastric cancer
KW - Signet ring gastric cancer
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U2 - 10.1016/j.jpedsurg.2019.01.048
DO - 10.1016/j.jpedsurg.2019.01.048
M3 - Article
C2 - 30824240
AN - SCOPUS:85062040154
SN - 0022-3468
VL - 54
SP - 1029
EP - 1034
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 5
ER -
