Gastric carcinoma is an extremely uncommon malignancy in children, and knowledge regarding its causes, epidemiology, and clinical presentation in the pediatric population remains limited. This study aimed to expand the understanding of the occurrence and characteristics of childhood gastric carcinoma. Cases of gastric carcinoma diagnosed between 2000 and 2017/2018 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database and the German Center for Cancer Registry Data. Patients under 20 years of age were examined for demographic and tumor-specific characteristics. Additionally, clinical information from pediatric gastric carcinoma patients registered in the German Registry for Rare Pediatric Tumors (STEP) was analyzed regarding diagnostic procedures, treatment approaches, and outcomes.
A total of 91 cases were identified in the population-based registries, predominantly affecting adolescents. Among patients with documented tumor staging, advanced stages were frequent (66.7%). During the reported follow-up, 63.7% of patients with clinical follow-up data died. Within the STEP registry, eight pediatric patients were included; two had hereditary CDH1 mutations and one had Peutz–Jeghers syndrome. Three patients exhibited notably low immunoglobulin levels. Complete surgical resection was achieved in four patients, all of whom remained in remission, whereas three of the four remaining patients succumbed despite receiving multimodal therapy. The development of gastric carcinoma in children appears to be influenced by a combination of Helicobacter pylori infection along with genetic predisposition and/or immunodeficiency. Complete surgical removal offers a strong chance of long-term remission for localized tumors, whereas stage IV disease is associated with a poor prognosis, underscoring the urgent need for innovative approaches such as mutation-targeted therapies.
