J Cancer 2020; 11(3):678-685. doi:10.7150/jca.37531

Research Paper

Young age increases risk for lymph node positivity in gastric cancer: A Chinese multi-institutional database and US SEER database study

Yuming Jiang1*, Weicai Huang1*, Jingjing Xie2*, Zhen Han1, Chuanli Chen3, Sujuan Xi4, Zepang Sun1, Yanfeng Hu1, Liying Zhao1, Jiang Yu1, Tuanjie Li1, Zhiwei Zhou5,6✉, Shirong Cai7✉, Guoxin Li1✉

1. Department of General Surgery, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, China;
2. Center for Drug and Clinical Research, Nanfang Hospital, Southern Medical University, Guangzhou, China;
3. Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue North, 510515 Guangzhou, China;
4. Guangdong Key Laboratory of Liver Disease Research, the 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China;
5. Department of Gastric Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, P. R. China, 510060;
6. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China, 510060;
7. Department of Gastrointestinal Surgery of the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510700, Guangdong, China.
*Yuming Jiang, Weicai Huang, and Jingjing Xie contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Citation:
Jiang Y, Huang W, Xie J, Han Z, Chen C, Xi S, Sun Z, Hu Y, Zhao L, Yu J, Li T, Zhou Z, Cai S, Li G. Young age increases risk for lymph node positivity in gastric cancer: A Chinese multi-institutional database and US SEER database study. J Cancer 2020; 11(3):678-685. doi:10.7150/jca.37531. Available from http://www.jcancer.org/v11p0678.htm

File import instruction

Abstract

Object: The risk of lymph node positivity (LN+) in gastric cancer (GC) impacts therapeutic recommendations. The aim of this study was to quantify the effect of younger age on LN+.

Methods: Data from a Chinese multi-institutional database and the US SEER database on stage I to III resected GC were analyzed for the relationship between age and LN+ status. The association of age and LN+ status was examined with logistic regression separately for each T stage, adjusting for multiple covariates. Poisson regression was used to evaluate age and number of LN+.

Results: 4,905 and 14,877 patients were identified in the China and SEER datasets respectively. 479 (9.8%) patients were under age 40 years, with 768 (15.7%) between age 40 and 49 years in China dataset, and 416 (2.8%) patients were under age 40 years, with 1176 (7.9%) between age 40 and 49 years in SEER dataset. Both datasets exhibited significantly proportional decreases of N3a and N3b LN+ with age increasing. Patients younger than age 40 years were more likely to show LN+ compared with the reference age 60 to 69 years. The youngest patients had the highest ORs of N1, N2, N3a, and N3b vs N0 LN+ within T4 stage of China dataset and T3 stage of SEER dataset, the values of ORs decreased with increasing age. Young age was a predictor of an increased number of LNs positive for each T stage.

Conclusion: In the two large datasets, young age at diagnosis is associated with an increased risk of LN+.

Keywords: gastric cancer, age, lymph node positivity