Published online Jul 15, 2026. doi: 10.4251/wjgo.v18.i7.122188
Revised: May 16, 2026
Accepted: June 2, 2026
Published online: July 15, 2026
Processing time: 84 Days and 13.1 Hours
Early-onset gastric cancer (EOGC) presents distinct clinicopathological features compared with late-onset gastric cancer. However, data on temporal trends and prognosis of EOGC in certain regions remain limited.
To investigate the temporal trends, clinicopathological features, and prognosis of EOGC in a regional cancer center over a 10-year period.
This single-center, retrospective study included newly diagnosed patients with EOGC (age ≤ 45 years and histopathologically confirmed gastric adenocarcinoma) admitted to Jiangxi Cancer Hospital between January 1, 2013, and December 31, 2022. Clinicopathological data were collected from medical records. Temporal trends were analyzed using the Cochran-Armitage trend χ2 test. Overall survival (OS) was estimated using the Kaplan-Meier survival curve, and survival diffe
A total of 687 patients were included, with a female predominance (53.28%). The most common primary location was the gastric body (67.83%), and diffuse-type histology predominated (90.15%); 35.92% of the patients tested positive for Helicobacter pylori. Common metastatic sites included lymph nodes (14.70%), ovaries (11.20%), and peritoneum (8.44%). From 2013 to 2022, the proportion of EOGC among all gastric cancers declined significantly from 12.05% to 6.53% (P = 0.000). However, within the EOGC population, the proportion of patients ≤ 35 years increased (P = 0.042). The proportion of overweight patients increased significantly (P = 0.010). The median OS of the entire cohort was 47.0 months, with 5-year and 10-year survival rates of 43.8% and 21.8%, respectively. Survival improved significantly over the 10-year period (P = 0.000), with median OS extending from 20-27 months in earlier years to 61-74 months in later years. Higher body mass index and radical gastrectomy were associated with better survival (both P < 0.01).
EOGC accounts for a decreasing proportion of all gastric cancers but presents at a younger age. The disease is characterized by female predominance, diffuse histology, and high propensity for peritoneal and ovarian metastasis. OS has improved markedly over time, likely due to increased rates of radical surgery, better nutritional status, and advances in systemic therapies.
Core Tip: Early-onset gastric cancer accounts for a decreasing proportion of all gastric cancers but presents at a younger age. The disease is characterized by female predominance, diffuse histology, and high propensity for peritoneal and ovarian metastasis. Overall survival has improved markedly over time, likely due to increased rates of radical surgery, better nutritional status, and advances in systemic therapies.