Treatment Variation Impacts Survival Among Patients With Early-Onset Metastatic Colorectal Cancer

Area of Science:

• Oncology
• Gastroenterology
• Cancer Research

Background:

• Rising incidence of early-onset colorectal cancer (eoCRC).
• Optimal management strategies for metastatic eoCRC are not well-defined.
• Comparison of treatment patterns between early-onset (eoCRC) and later-onset (loCRC) metastatic colorectal cancer patients.

Purpose of the Study:

• To characterize and compare treatment patterns in metastatic eoCRC versus loCRC.
• To evaluate the impact of different treatment regimens on survival outcomes in metastatic eoCRC patients.

Main Methods:

• Retrospective analysis of stage IV colorectal cancer (CRC) patients diagnosed between 2004 and 2022.
• Stratification of patients by age: eoCRC (<50 years) and loCRC (≥50 years).
• Comparison of treatment modalities including systemic chemotherapy (CT), primary resection (PR), immunotherapy (IO), and metastasis resection (MR) across age groups.

Main Results:

• 15.6% of 259,435 stage IV CRC patients were classified as eoCRC.
• eoCRC patients were more likely to receive multimodal regimens (CT/PR, CT/PR/MR, CT/PR/IO) compared to loCRC patients (p < 0.05).
• Multimodal therapies in eoCRC patients, including CT/PR, CT/PR/MR, and CT/PR/IO, were associated with significant survival benefits compared to CT alone.

Conclusions:

• Metastatic eoCRC patients more frequently undergo aggressive, multimodal therapy.
• Aggressive, multimodal therapy is associated with improved survival in patients with metastatic eoCRC.