Published online Feb 14, 2023. doi: 10.3748/wjg.v29.i6.1090
Peer-review started: August 24, 2022
First decision: November 5, 2022
Revised: December 11, 2022
Accepted: January 5, 2023
Article in press: January 5, 2023
Published online: February 14, 2023
The impact of racial and regional disparity on younger patients with gastric cancer (GC) remains unclear.
This study aimed to provide a national view of younger GC patients in China and the United States.
To investigate the clinicopathological characteristics, prognostic nomogram, and biological analysis of younger GC patients in China and the United States.
From 2000 to 2018, GC patients aged less than 40 years were selected from the China National Cancer Center and the Surveillance Epidemiology and End Results database. Biological analysis was enrolled from the Gene Expression Omnibus database.
A total of 6098 younger GC patients were selected from 2000 to 2018, of which 1159 were enrolled in the China National Cancer Center, and 4939 were collected from the Surveillance Epidemiology and End Results database. Compared with the United States group, younger patients in China revealed better survival outcomes (P < 0.01). For race/ethnicity, younger Chinese cases also enjoyed a better prognosis than that in White and Black subsets (P < 0.01). Prognostic nomograms for younger patients were established, with area under the curves of 0.786 for China and 0.842 for the United States. Moreover, three gene expression profiles (GSE27342, GSE51105, and GSE38749) were enrolled in further biological analysis, and distinctive molecular characteristics were identified in younger GC patients in different regions.
Except for younger cases with pathological Tumor-Node-Metastasis stage II, a survival advantage was observed in the China group with pathological stages I, III, and IV. Biological analysis of younger patients was performed among different regions, which might partly explain the histopathological behaviors and survival disparity in the subpopulations.
Further large-scale studies are warranted to investigate more molecular characteristics and related mechanisms for younger GC patients among different regions and races.