[Comparative study of clinical characteristics and prognosis between early- and late-onset rectal cancer]
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View abstract on PubMed
Summary
This summary is machine-generated.Early-onset rectal cancer (EORC) presents at later stages and has poorer outcomes than late-onset rectal cancer (LORC). However, early diagnosis and prompt treatment can significantly improve survival for EORC patients.
Area Of Science
- Oncology
- Gastroenterology
- Clinical Research
Background
- Rectal cancer incidence is increasing in younger populations, necessitating investigation into early-onset rectal cancer (EORC) versus late-onset rectal cancer (LORC).
- Understanding clinical characteristics and prognostic differences is crucial for optimizing treatment strategies in distinct age groups.
- Identifying adverse prognostic factors specific to EORC can guide early intervention and improve patient outcomes.
Purpose Of The Study
- To compare clinical features and prognosis between early-onset rectal cancer (EORC) and late-onset rectal cancer (LORC).
- To identify independent risk factors influencing overall survival (OS) and progression-free survival (PFS) in EORC patients.
- To analyze the relationship between age and clinical outcomes in rectal cancer patients.
Main Methods
- Retrospective cohort study of 904 rectal cancer patients undergoing radical resection (2017-2022).
- Propensity score matching (PSM) at a 1:2 ratio to balance confounders between EORC (<50 years) and LORC (≥50 years) groups.
- Multivariate Cox regression and restricted cubic spline analyses to determine risk factors and age-outcome associations.
Main Results
- Prior to PSM, EORC patients exhibited higher rates of advanced T4 and M1 disease, and received more neoadjuvant and adjuvant therapy.
- Initially, LORC patients showed longer mean OS and PFS, but these differences became non-significant after PSM.
- In EORC, elevated carcinoembryonic antigen (CEA) levels (≥5 μg/L) and perineural invasion were independent predictors of mortality; high CEA also predicted cancer progression.
Conclusions
- Early-onset rectal cancer (EORC) is frequently diagnosed at later stages and associated with poorer prognosis compared to late-onset rectal cancer (LORC).
- Key adverse factors for EORC include elevated CEA levels and perineural invasion, highlighting targets for risk stratification.
- While age showed a U-shaped association with outcomes, PSM indicated no significant age-related survival difference within younger cohorts, emphasizing the importance of stage and treatment.
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