Pediatric gastric adenocarcinoma: A National Cancer Data Base review

Robert A. Tessler, Matthew Dellinger, Morgan K. Richards, Adam B. Goldin, Elizabeth A. Beierle, John J. Doski, Melanie Goldfarb, Monica Langer, Jed G. Nuchtern, Mehul V Raval, Sanjeev Vasudevan, Kenneth W. Gow*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

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

Original languageEnglish (US)
Pages (from-to)1029-1034
Number of pages6
JournalJournal of pediatric surgery
Volume54
Issue number5
DOIs
StatePublished - May 2019

Keywords

  • Pediatric gastric adenocarcinoma
  • Pediatric gastric cancer
  • Signet ring gastric cancer

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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