Research Paper|Volume 12, Issue 18|pp 18137—18150

The clinicopathological characteristics and genetic alterations between younger and older gastric cancer patients with curative surgery

Chew-Wun Wu^1,², Ming-Huang Chen^2,³, Kuo-Hung Huang^1,², Shih-Ching Chang^2,⁴, Wen-Liang Fang^1,², Chien-Hsing Lin⁵, Yee Chao^2,³, Su-Shun Lo^2,⁶, Anna Fen-Yau Li^2,⁷, Yi-Ming Shyr^1,²

¹Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
²School of Medicine, National Yang-Ming University, Taipei, Taiwan
³Center of Immuno-Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
⁴Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
⁵Genome Research Center, National Yang-Ming University, Taipei, Taiwan
⁶National Yang-Ming University Hospital, Yilan, Taiwan
⁷Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan

Received: March 28, 2020Accepted: June 22, 2020Published: August 18, 2020

https://doi.org/10.18632/aging.103627

Copyright: © 2020 Wu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Few reports have investigated different genetic alterations according to age in various cancers. In total, 1749 GC patients receiving curative surgery were enrolled. The clinicopathological features, and prognoses were compared between younger (<65 years) and older (≥65 years) patients. Genetic mutations were analyzed using mass spectrometric single nucleotide polymorphism genotyping technology, including 68 validated mutations within eight genes (TP53, ARID1A, BRAF, and the PI3K/AKT pathway) previously reported in relation to age. Younger patients were more likely to be female and have poor cell differentiation, diffuse-type tumors, less lymphovascular invasion, fewer liver metastases, and better 5-year overall survival (OS) (68.0% vs. 54.6%, P<0.001) and disease-free survival (DFS) (65.4% vs. 53.0%, P<0.001) rates than older patients. Regarding the genetic alterations, older patients had more microsatellite instability-high (MSI-H) tumors and more ARID1A mutations than younger patients. Younger patients had significantly better OS and DFS rates than older patients for each pathological Tumor, Node, Metastasis (TNM) stage. Older patients had a significantly higher non-cancer related death rate than younger patients (36.2% vs. 12.3%, P<0.001). Age was an independent prognostic factor in GC. In conclusion, age was associated with different clinicopathological features and genetic alterations in GC with curative surgery.