Advanced signet ring cell type gastroesophageal cancers in Latin American patients age 40 and below: A summary of one tertiary care center's experience and a review of the literature.

person Timothy Lewis Cannon Inova Schar Cancer Institute, Fairfax, VA info_outline Timothy Lewis Cannon, Jamie Randall, Whitney Rose Swain, Haresh Mani, Raymond Couric Wadlow, Jasmine Huynh, Arthur Winer

Authors person Timothy Lewis Cannon Inova Schar Cancer Institute, Fairfax, VA info_outline Timothy Lewis Cannon, Jamie Randall, Whitney Rose Swain, Haresh Mani, Raymond Couric Wadlow, Jasmine Huynh, Arthur Winer Organizations Inova Schar Cancer Institute, Fairfax, VA, Inova Fairfax Hospital, Fairfax, VA Abstract Disclosures Research Funding No funding sources reported Background: Gastric Cancer mortality rates in Latin American countries of Central and South America (LA) are among the highest in the world. After observing multiple cases of advanced gastric adenocarcinoma (GA) with signet ring cell differentiation in young immigrants from LA, we sought to understand the prevalence and demographics of young-onset gastric cancer at our institution. Methods: We used the Inova Fairfax Hospital cancer registry to perform a retrospective cohort study by identifying all patients ≤ 40 from 2013-2022 with 1) GA, and 2) all cancers, and comparing the percentage of LA patients in each group. We noted a trend towards high rates of GC in young immigrants of LA six years ago, and now provide an updated analysis. We then reviewed phenotypic characteristics of each tumor, including signet ring cell differentiation, Her-2/Neu overexpression, and H. Pylori status and the time interval between diagnosis and death. Results: From 2013-2022, 21/37 patients (56.8%) ≤ 40 with GA were from LA (Table 1), with the majority from El Salvador. 95% (20/21) of LA patients had tumors with signet ring cell morphology, 88% (14/16) of non-LA patients had tumors with signet ring cell morphology. In comparison, patients that self-identified as “Hispanic/Spanish” made up 8.1% of subjects ≤ 40 with all cancers during the same time period. Conclusions: At our tertiary care center, Stage IV signet ring cell gastric cancer is highly prevalent in young patients from Latin America. Further exploration of epidemiological risk factors is warranted. Patient characteristics of Latin American cohort. Subject # Age Sex (M/F) Country of Origin Interval Between Diagnosis and Death (Months) Signet Ring Cell Morphology (Y/N) H.Pylori Detected (Y/N) Her-2/Neu Positive (Y/N) 1 39 F El Salvador 9 Y Y N 2 35 F Guatemala Alive Y n/a N 3 38 F Mexico 2 Y n/a N 4 35 F Mexico Alive Y N N 5 26 M El Salvador < 1 Y Y N 6 35 F Bolivia 7 Y n/a N 7 26 M Guatemala Alive Y N N 8 33 F El Salvador 5 Y Y N 9 40 F El Salvador Alive Y n/a N 10 33 M Honduras Alive Y N N 11 39 F Mexico 3 Y Y N 12 37 F El Salvador Unknown Y Y N 13 32 F Honduras 13 Y Y N 14 34 F El Salvador > 23 Y Y N 15 27 M El Salvador 9 Y Y N 16 36 F El Salvador 9 Y N N 17 29 F El Salvador > 79 Y N N 18 40 F Honduras 12 N N N 19 28 F El Salvador > 3 Y Y N 20 30 F El Salvador 8 Y N N 21 40 F Bolivia 13 Y Y N