Clinicopathological features and prognosis of patients &lt;45 years old with esophageal adenocarcinoma comparing to other age groups

Yang, Sheng; Li, Haibo; Jia, Chunyi; Ma, Xiao; Guo, Wei; Li, Hecheng

doi:10.21037/jtd.2016.09.61

Cited by 9 publications

(7 citation statements)

References 19 publications

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“…The prognosis of young EAC patients is still controversial. Some studies have reported that young patients with EAC presented with a more advanced stage of the disease and had poorer survival than older EAC patients[11,12,21]. In our cohort, the outcomes of endoscopic treatment for T1 EAC or HGD between both groups were similar.…”

Section: Discussionsupporting

confidence: 52%

Clinical characteristics of young patients with early Barrett’s neoplasia

Iwaya

Shimamura

Goda

et al. 2019

WJG

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BACKGROUND Esophageal adenocarcinoma (EAC) and high-grade dysplasia (HGD) may appear in young patients with Barrett’s esophagus (BE). However, characteristics of Barrett’s-related neoplasia in this younger population remain unknown. AIM To identify clinical characteristics that differ between young and old patients with early-stage Barrett’s-related neoplasia. METHODS We conducted a retrospective analysis of a prospectively maintained database comprised of consecutive patients with early-stage EAC (pT1) and HGD at a tertiary-referral center between 2001 and 2017. Baseline characteristics, drug and risk factor exposures, clinicopathological staging of EAC/HGD and treatment outcomes [complete eradication of neoplasia (CE-N), complete eradication of intestinal metaplasia (CE-IM), recurrence of neoplasia and recurrence of intestinal metaplasia] were retrieved. Multivariate analyses were performed to identify factors that differed significantly between older and younger (≤ 50 years) patients. RESULTS We identified 450 patients with T1 EAC and HGD (74% and 26%, respectively); 45 (10%) were ≤ 50 years. Compared to the older group, young patients were more likely to present with ongoing gastroesophageal reflux disease (GERD) symptoms (55% vs 38%, P = 0.04) and to be obese (body mass index > 30, 48% vs 32%, P = 0.04). Multivariate logistic regression analysis showed that young patients were significantly more likely to have ongoing GERD symptoms [odds ratio (OR) 2.00, 95% confidence interval (CI) 1.04-3.85, P = 0.04] and to be obese (OR 2.06, 95%CI 1.07-3.98, P = 0.03) whereas the young group was less likely to have a smoking history (OR 0.39, 95%CI 0.20-0.75, P < 0.01) compared to the old group. However, there were no significant differences regarding tumor histology, CE-N, CE-IM, recurrence of neoplasia and recurrence of intestinal metaplasia (mean follow-up, 44.3 mo). CONCLUSION While guidelines recommend BE screening in patients > 50 years of age, younger patients should be considered for screening endoscopy if they suffer from obesity and GERD symptoms.

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Section: Discussionsupporting

confidence: 52%

Clinical characteristics of young patients with early Barrett’s neoplasia

Iwaya

Shimamura

Goda

et al. 2019

WJG

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“…A total of 3647 records were identified through database searching and cross-referencing. Overall, 8 studies were included for qualitative synthesis of which 7 studies were included for quantitative analysis (meta-analysis) with 4991 and 4847 patients respectively[ 13 , 20 - 26 ].…”

Section: Resultsmentioning

confidence: 99%

Outcomes of curative esophageal cancer surgery in elderly: A meta-analysis

Baranov¹,

Slootmans

Workum

et al. 2021

WJGO

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BACKGROUND An increasing number of older patients is undergoing curative, surgical treatment of esophageal cancer. Previous meta-analyses have shown that older patients suffered from more postoperative morbidity and mortality compared to younger patients, which may lead to patient selection based on age. However, only studies including patients that underwent open esophagectomy were included. Therefore, it remains unknown whether there is an association between age and outcome in patients undergoing minimally invasive esophagectomy. AIM To perform a systematic review on age and postoperative outcome in esophageal cancer patients undergoing esophagectomy. METHODS Studies comparing older with younger patients with primary esophageal cancer undergoing curative esophagectomy were included. Meta-analysis of studies using a 75-year age threshold are presented in the manuscript, studies using other age thresholds in the . MEDLINE, Embase and the Cochrane Library were searched for articles published between 1995 and 2020. Risk of bias was assessed with the Newcastle-Ottawa Scale. Primary outcomes were anastomotic leak, pulmonary and cardiac complications, delirium, 30- and 90-d, and in-hospital mortality. Secondary outcomes included pneumonia and 5-year overall survival. RESULTS Seven studies (4847 patients) using an age threshold of 75 years were included for meta-analysis with 755 older and 4092 younger patients. Older patients (9.05%) had higher rates of 90-d mortality compared with younger patients (3.92%), (confidence interval = 1.10-5.56). In addition, older patients (9.45%) had higher rates of in-hospital mortality compared with younger patients (3.68%), (confidence interval = 1.01-5.91). In the subgroup of 2 studies with minimally invasive esophagectomy, older and younger patients had comparable 30-d, 90-d and in-hospital mortality rates. CONCLUSION Older patients undergoing curative esophagectomy for esophageal cancer have a higher postoperative mortality risk. Minimally invasive esophagectomy may be important for minimizing mortality in older patients.

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“…Furthermore, owing to being often diagnosed at an advanced stage at the time of consultation, esophageal cancer has a poor prognosis [8]. It is still controversial whether younger patients with EC have a better or worse prognosis than older patients, which draws our attention to which clinicopathological factors affect the prognosis of young patients with esophageal cancer [9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Construction and verification of prognostic nomogram for early-onset esophageal cancer

Liu

Wei

Shi

et al. 2021

Bosn J of Basic Med Sci

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This study aimed to build up nomogram models to evaluate overall survival (OS) and cancer-specific survival (CSS) in early-onset esophageal cancer (EOEC). Patients diagnosed with esophageal cancer (EC) from 2004 to 2015 were extracted from the Surveillance Epidemiology and End Results (SEER) database. Clinicopathological characteristics of younger versus older patients were compared, and survival analysis was performed in both groups. Independent related factors influencing the prognosis of EOEC were identified by univariate and multivariate Cox analysis, which were incorporated to construct a nomogram. The predictive capability of the nomogram was estimated by the concordance index (C-index), calibration plot, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). A total of 534 younger and 17,243 older patients were available from the SEER database. Younger patients were randomly segmented into a training set (n=266) and a validation set (n=268). In terms of the training set, the C-index of the OS nomogram was 0.740 (95% CI: 0.707-0.773), and that of the CSS nomogram was 0.752 (95% CI: 0.719-0.785). In view of the validation set, the C-index of OS and CSS were 0.706 (95% CI: 0.671-0.741) and 0.723 (95%CI: 0.690-0.756), respectively. Calibration curves demonstrated the consistent degree of fit between actual and predicted values in nomogram models. From the perspective of DCA, the nomogram models were more beneficial than the tumor-node-metastasis (TNM) and the SEER stage for EOEC. In brief, the nomogram model can be considered as an individualized quantitative tool to predict the prognosis of EOEC patients to assist clinicians in making treatment decisions.

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Clinicopathological features and prognosis of patients <45 years old with esophageal adenocarcinoma comparing to other age groups

Cited by 9 publications

References 19 publications

Clinical characteristics of young patients with early Barrett’s neoplasia

Clinical characteristics of young patients with early Barrett’s neoplasia

Outcomes of curative esophageal cancer surgery in elderly: A meta-analysis

Construction and verification of prognostic nomogram for early-onset esophageal cancer

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