Among 4608 patients with gastric carcinoma treated during a 20-year pe
riod from 1971 to 1990, 328 (7.1%) were less than 40 years of age. The
clinicopathologic features and treatment results in this young group
were compared with those for older gastric carcinoma patients (40-79 y
ears of age, control group). In the young group, the male/female ratio
and the prevalence of tumors in the lower third of the stomach were b
oth lower than in the control group, and undifferentiated-type adenoca
rcinomas with diffusely infiltrative growth predominated. The TNM stag
e distribution and the proportion of curative resections were similar
in the two groups. The overall cumulative 5-year survival rates were a
lso similar, although that of patients who underwent curative resectio
n was higher in the young group, due probably to the low rate of death
from other causes. There was no difference in the recurrence rates af
ter curative resection between the two groups. Contrary to widely held
belief, the prognosis of young patients with gastric carcinoma is not
poorer than that of older patients if the disease is diagnosed at a r
easonably early stage.