To analyze the clinical features and prognosis of patients with early-onset gastric cancer (EOGC).

A retrospective study was conducted, including 4 712 patients with gastric cancer who underwent surgical treatment in the First Affiliated Hospital of Anhui Medical University from January 2012 to December 2018. The difference in clinicopathological features between the patients with EOGC and those with non-EOGC was compared by propensity score matching. Follow-up data and survival curves were used to analyze the prognosis of patients, and the prognosis factors between the two groups was analyzed by univariate and multivariate regression analysis, ultimately establishing a nomogram model to predict overall survival in EOGC patients.

There were 298 EOGC patients and 4 414 non-EOGC patients. After propensity score matching analysis, 229 patients in the EOGC group and 458 patients in the non-EOGC group were enrolled. Vascular invasion and differentiation showed significantly differences between the two groups (P<0.05). The median survival time for the EOGC group was 56.06 months (1 682 days), significantly shorter than 69.1 months (2 073 days) for the non-EOGC group. Multivariate analysis results indicated that age, maximum tumor diameter, the number of lymph nodes retrieved, the number of positive lymph node, TNM staging, and history of stroke were the prognsic factors for EOGC patients (all P<0.05). Based on the the above factors, a nomogram model was established to predict the overall survival of EOGC patients. The AUC for the nomogram model predicting 1, 5, and 8-year survival rates were 0.770 (95% CI: 0.724-0.816), 0.791 (95% CI: 0.750-0.831), 0.802 (95% CI: 0.730-0.875), respectively, showing good prognostic accuracy.

EOGC is a rare disease with obviously worse prognosis than that of non-EOGC patients, warranting further clinical attention. The established nomogram model can effectively predict the prognosis of EOGC patients.