Abstract: Objective To investigate the effects of clinical characteristics on the survival of young, middle and old-aged patients with gastric cardia adenocarcinoa (GCA). Methods A total of 5 000 GCA patients were divided into three groups based on the age at diagnosis, i.e., young (<50 years), middle (≥50-70 years) and old-aged(≥70 years ) group. Chi-square test, Kaplan-Meier survival curves, Log-rank test and multivariate Cox regression model were applied to assess the factors for GCA survival. Results Firstly, the percent of young, middle and old-aged group were 6.1% (n=303), 75.0% (n=3 751) and 18.9% (n= 946), respectively.Overall gender ratio of male to female was 3.1:1.The gender ratios in young, middle and old-aged group were 2.3:1, 3.0:1 and 3.7:1, respectively (P<0.05).Secondly, in the young-aged group, the rates of low differentiation and lymph node metastasis were signifi cantly higher than those in middle and old-aged patients (P<0.05), and the prevalence of T3 and T4 was higher than that in middle-aged patients,while lower than that in old-aged group(P<0.05). Moreover, based on TNM staging, the rate of Ⅲ-Ⅳin the young-aged group was higher than that in middle or old-aged group (P<0.05). Thirdly, the median survival time in the young, middle and old-aged group were 5.1, 4.4 and 3.5 years, respectively. The survival time in young and middle-aged group were signifi cantly longer than that in old-aged group (P <0.05). Conclusion Age of diagnosis, gender, depth of invasion, number of lymph node metastasis, TNM stage, differentiation degree are the independent risk factors significantly correlated with GCA prognosis.The overall malignancy profile in young GCA patients who although had better prognosis,was in middle and old-aged patients.