Esophageal cancer in patients under 50: a SEER analysis

Zeng, Yuan; Ruan, Wenli; Lee, Jun; Liang, Wenhua; He, Jiaxi; Cui, Fei; Hui, Pei

doi:10.21037/jtd.2018.05.72

Cited by 17 publications

(19 citation statements)

References 20 publications

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“…7,8 Our findings support previous studies that demonstrated advanced disease presentation in younger patients. 14,15,[17][18][19] Furthermore, results of our analysis demonstrated that the incidence of metastatic disease at diagnosis decreased with increasing age quartile. Use of age 50 years and 60 years as cutoffs demonstrated that the rate of distant disease was approximately 30% higher for younger patients in both analyses.…”

Section: Discussionmentioning

confidence: 60%

“…14,15,17,23 Although some studies demonstrate improved 5-year overall survival among younger patients, others fail to replicate these findings. [14][15][16][17][18][19]23 In this series, patients aged less than 75 years had a similar rate of receiving any surgical therapy, although patients aged less than 65 years were more likely to receive aggressive treatment with induction therapy þ surgery than older patients. However, stratification by stage demonstrated that the magnitude of survival benefits among younger patients decreased with increasing stage.…”

Section: Discussionmentioning

confidence: 82%

“…Use of age 50 years and 60 years as cutoffs demonstrated that the rate of distant disease was approximately 30% higher for younger patients in both analyses. In the only other population-based study, Zeng and colleagues 18 recently used Surveillance, Epidemiology, and End Results program data to evaluate 1385 patients aged 50 years or less and demonstrated that 48.5% presented with distant disease compared with 37.9% of older patients.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Furthermore, perceptions of esophageal cancer as a rare disease in young patients may result in lower clinical suspicion; as such, some studies have suggested that patients aged less than 50 years are more likely to have delayed diagnosis and consequently more advanced disease. [14][15][16][17][18] Given that 5-year overall survival for advanced disease is 25% and less than 5% for regional and distant disease, respectively, earlier identification has a significant impact on prognosis. 3 To date, esophageal cancer in young patients has received minimal attention in the literature.…”

Section: Perspectivementioning

confidence: 99%

“…Most studies are single-institution experiences limited by small sample sizes and conflicting findings relating to the presentation, treatment, and prognosis of this population; as such, the clinicopathologic presentation and outcomes of esophageal cancer in young patients are not well defined. [14][15][16][17][18][19][20][21][22][23][24][25] Further complicating current understanding of this disease in young patients is the lack of consensus as to what constitutes a ''young patient,'' with many studies arbitrarily selecting age less than 50 years. [14][15][16][17][18][19][20][21] Given that survival for this disease remains poor, esophageal cancer in young patients merits further investigation to better guide diagnosis and management in this population.…”

Section: Perspectivementioning

confidence: 99%

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Higher clinical suspicion is needed for prompt diagnosis of esophageal adenocarcinoma in young patients

Nobel

Curry

Gennarelli

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

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Background: Esophageal cancer is considered a disease of the elderly. Although the incidence of esophageal adenocarcinoma in young patients is increasing, current guidelines for endoscopic evaluation of gastroesophageal reflux disease and Barrett's esophagus include age as a cutoff. There is a paucity of data on the presentation and treatment of esophageal cancer in young patients. Most studies are limited by small sample sizes, and conflicting findings are reported regarding delayed diagnosis and survival compared with older patients.Methods: A retrospective cohort study was performed using the National Cancer Database between 2004 and 2015. Patients with esophageal adenocarcinoma were divided into quartiles by age (18-57, 58-65, 66-74, 75þ years) for comparison. Clinicopathologic and treatment factors were compared between groups.From the

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Perspectivementioning

confidence: 99%

Section: Perspectivementioning

confidence: 99%

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Higher clinical suspicion is needed for prompt diagnosis of esophageal adenocarcinoma in young patients

Nobel

Curry

Gennarelli

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

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Chemoradiotherapy vs radiotherapy for nonoperative early stage esophageal cancer: A seer data analysis

Jia

Cheng

et al. 2020

Cancer Medicine

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Background The benefit of endoscopic treatment (ET) and esophagectomy for early esophageal cancer (EC) has been sufficiently recognized. Radiotherapy (RT) is the main treatment modality for patients who do not undergo surgery. The effectiveness of adding chemotherapy (CT) to RT remains unclear. This study aimed to evaluate the impact of chemoradiotherapy (CRT) and RT alone on overall survival (OS) and cancer‐specific survival (CSS) in early EC patients not undergoing surgery. Methods Data collected between 2004 and 2015 were obtained from the national Surveillance, Epidemiology, and End Results (SEER) database. All the samples were randomly grouped into the training cohort or the verification cohort. The training cohort was split into subgroups by stage, age, and histology. Stage was based on the American Joint Committee on Cancer (AJCC) 6th edition published in 2004. The Kaplan‐Meier method and Cox proportional hazards modeling were used to compare OS and CSS. The performance of the nomogram was measured by a concordance index (C‐index) and the calibration curve. Results Data for a total of 5332 patients were obtained from the SEER database. A total of 3736 patients (stage I: n = 1277; stage IIA: n = 1484; stage IIB: n = 975) were used for the training cohort. Multivariate Cox regression analysis showed that age, sex, histology, grade, therapy, reasons for no surgery, and year of diagnosis were independent predictors of OS. The survival curve of patients treated with CRT showed a significant survival benefit compared to that in patients treated by RT alone in stage I, stage IIA, and stage IIB. CRT was also found to be related to better survival than RT in patients at a younger age (<65) and an older age (≥65) with squamous cell carcinoma or adenocarcinoma. Conclusions Compared with RT, CRT results in better OS and CSS in early EC patients who do not undergo surgery.

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Digestive tract neoplasms in young individuals: Demographics, staging and risk factors

Tasneem

Luck

2020

Cancer Reports

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Background Digestive tract neoplasms (DTN) have become increasingly common worldwide among young individuals (YIs) over the last few decades. Aim Aim of this research was to study the types, demographics, stage at presentation and risk factors of digestive tract neoplasms in young individuals. Methods and results In this cross‐sectional study, YI (ie, ≤40 years) presenting with any DTN including gastrointestinal neoplasms (GIN), hepatobiliary neoplasms (HBN), periampullary neoplasms (PAN) and others from June 2016 to May 2020 were included. Baseline laboratory tests, tissue diagnosis and staging were performed while risk factors were documented. A total of 163 patients were included in the study, of whom 82 (50.3%) were males. Mean age was 29.9 (±9.57) (range: 8 months‐40 years). Most DTN (93.3%; n = 152) were malignant. The commonest neoplasms were lower GIN (LGIN) 52 (31.9%), followed by HBN 46 (28.2%), upper GIN (UGIN) 44 (27%) and PAN 18 (11%). Commonest among LGIN were rectal 37; among HBN: hepatocellular cancer (HCC) 9, cholangiocarcinoma (CC) 9; and among UGIN: esophageal 25 and stomach 14. Rectal cancers were mostly sporadic (82.7%) with frequent signet ring cell histology (40.5%), and affected relatively younger ages compared to upper GIN and PAN. GIN were mostly locally advanced with higher resectability (LGIN 90.4%; UGIN 79.5%) while HBN were more advanced with lower resectability (HCC [44.4%]; CC [33.3%]). Poor dietary habits and poor socioeconomic status were common with UGIN (63.6%, 50%) and HBN (56.5%, 54.3%), respectively. Conclusion The commonest DTN among YI were LGIN followed by HBN, UGIN and PAN. Rectal cancers affected relatively younger ages and were mostly sporadic. HBN were more advanced in stage and unresectable compared to GIN. Poor dietary habits and poor socioeconomic status may be important contributors in carcinogenesis.

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Esophageal cancer in patients under 50: a SEER analysis

Cited by 17 publications

References 20 publications

Higher clinical suspicion is needed for prompt diagnosis of esophageal adenocarcinoma in young patients

Higher clinical suspicion is needed for prompt diagnosis of esophageal adenocarcinoma in young patients

Chemoradiotherapy vs radiotherapy for nonoperative early stage esophageal cancer: A seer data analysis

Digestive tract neoplasms in young individuals: Demographics, staging and risk factors

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