Clinicopathological characteristics and survival outcomes of early-onset vs mid-aged gastric cancer using an evidence-based age cutoff

doi:10.3748/wjg.120795

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Nov 28, 2026; 32(44): 120795
Published online Nov 28, 2026. doi: 10.3748/wjg.120795

Table 1 Baseline characteristics of study populations, n (%)/mean ± SD

Variables	EOGC (n = 105)	M-GC (n = 532)	P value
Age (year)	44.51 ± 4.25	63.95 ± 7.16	< 0.001
Sex			0.101
Male	70 (66.67)	396 (74.44)
Female	35 (33.33)	136 (25.56)
BMI (kg/m²)	24.22 ± 4.03	23.84 ± 3.69	0.357
Underlying disease	33 (31.43)	308 (57.89)	< 0.001
Previous history of other malignancies	4 (3.81)	42 (7.89)	0.139
CCI score	2.66 ± 1.31	4.50 ± 1.43	< 0.001
Extent of resection			0.369
Subtotal gastrectomy	72 (68.57)	399 (75.00)
Total gastrectomy	26 (24.76)	108 (20.30)
Palliative resection	7 (6.67)	25 (4.70)
pTNM stage			0.290
I	49 (46.67)	298 (56.02)
II	24 (22.86)	104 (19.55)
III	24 (22.86)	105 (19.74)
IV	8 (7.62)	25 (4.70)

EOGC: Early-onset gastric cancer; M-GC: Mid-aged gastric cancer; BMI: Body mass index; CCI: Charlson comorbidity index; pTNM: Pathological tumor node metastasis.

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Table 2 Comparison of pathologic results of patients with radical resection, n (%)/mean ± SD

Variables	EOGC (n = 97)	M-GC (n = 503)	P value
pT stage			0.521
T1a	26 (26.80)	126 (25.05)
T1b	23 (23.71)	156 (31.01)
T2	9 (9.28)	54 (10.74)
T3	25 (25.77)	99 (19.68)
T4	14 (14.43)	68 (13.52)
pN stage			0.777
N0	60 (61.86)	325 (64.61)
N1	11 (11.34)	64 (12.72)
N2	10 (10.31)	50 (9.94)
N3	16 (16.49)	64 (12.72)
Tumor size (cm)	4.47 ± 3.23	4.08 ± 2.87	0.228
Number of retrieved LNs	37.79 ± 12.94	35.28 ± 14.20	0.094
Number of metastatic LNs	3.73 ± 10.15	2.66 ± 6.19	0.545
Multiplicity			0.782
Single lesion	94 (96.91)	482 (95.83)
Multiple lesions	3 (3.09)	21 (4.17)
Lauren classification			< 0.001
Intestinal type	25 (25.77)	277 (55.07)
Diffuse type	51 (52.58)	112 (22.27)
Mixed type	15 (15.46)	69 (13.72)
Indeterminate type	6 (6.19)	45 (8.95)
LV invasion	24 (24.74)	177 (35.19)	0.046
PN invasion	33 (34.02)	122 (24.25)	0.044
Extent of omentectomy			0.916
Total omentectomy	37 (38.14)	189 (37.57)
Partial omentectomy	60 (61.86)	314 (62.43)
Postoperative complications			0.242
No	93 (95.88)	482 (95.83)
CDC I	2 (2.06)	3 (0.60)
> CDC II	2 (2.06)	18 (3.58)
In-hospital mortality	0 (0.0)	2 (0.40)	1
Adjuvant CTx	44 (45.36)	153 (30.42)	0.004

EOGC: Early-onset gastric cancer; M-GC: Mid-aged gastric cancer; LV: Lymphovascular; PN: Perineural; CDC: Clavien-Dindo classification; LN: Lymph node; CTx: Chemotherapy.

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Table 3 Hazard ratios of recurrence-free survival by pathological stage

		Unadjusted		IPTW-adjusted
		HR (95%CI)	P value	HR (95%CI)	P value
pStage I	M-GC	1.00	0.064	1.00	0.234
pStage I	EOGC	0.38 (0.14-1.06)	0.064	0.60 (0.26-1.40)	0.234
pStage II	M-GC	1.00	0.080	1.00	0.136
pStage II	EOGC	0.47 (0.17-1.10)	0.080	0.50 (0.20-1.25)	0.136
pStage III	M-GC	1.00	0.043	1.00	0.032
pStage III	EOGC	0.53 (0.29-0.98)	0.043	0.50 (0.26-0.94)	0.032
Total population	M-GC	1.00	0.014	1.00	0.021
Total population	EOGC	0.57 (0.36-0.89)	0.014	0.50 (0.38-0.93)	0.021

IPTW: Inverse probability of treatment weighting; HR: Hazard ratio; CI: Confidence interval; M-GC: Mid-aged gastric cancer; EOGC: Early-onset gastric cancer.

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Table 4 Hazard ratios of overall survival by pathological stage

		Unadjusted		IPTW-adjusted
		HR (95%CI)	P value	HR (95%CI)	P value
pStage I	M-GC	1.00	0.051	1.00	0.016
pStage I	EOGC	0.31 (0.10-1.00)	0.051	0.32 (0.10-1.03)	0.016
pStage II	M-GC	1.00	0.095	1.00	0.225
pStage II	EOGC	0.42 (1.48-1.16)	0.095	0.55 (0.21-1.44)	0.225
pStage III	M-GC	1.00	0.125	1.00	0.120
pStage III	EOGC	0.62 (0.34-1.14)	0.125	0.61 (0.32-1.14)	0.120
pStage IV	M-GC	1.00	0.222	1.00	0.052
pStage IV	EOGC	0.60 (0.27-1.36)	0.222	0.34 (0.11-1.01)	0.052
Total population	M-GC	1.00	0.072	1.00	0.016
Total population	EOGC	0.69 (0.46-1.03)	0.072	0.58 (0.37-0.90)	0.016

IPTW: Inverse probability of treatment weighting; HR: Hazard ratio; CI: Confidence interval; M-GC: Mid-aged gastric cancer; EOGC: Early-onset gastric cancer.

Full Size Table

Citation: Jeong SA, Lee JB, Kim JH. Clinicopathological characteristics and survival outcomes of early-onset vs mid-aged gastric cancer using an evidence-based age cutoff. World J Gastroenterol 2026; 32(44): 120795
URL: https://www.wjgnet.com/1007-9327/full/v32/i44/120795.htm
DOI: https://dx.doi.org/10.3748/wjg.120795

Jeong SA, Lee JB, Kim JH. Clinicopathological characteristics and survival outcomes of early-onset vs mid-aged gastric cancer using an evidence-based age cutoff. World J Gastroenterol 2026; 32(44): 120795 [DOI: 10.3748/wjg.120795]

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