Survival outcomes in early-onset oesophageal adenocarcinoma patients:A systematic review and meta-analyses

作     者：Ashleigh Russell Shauna Mitchell Richard C Turkington Helen G Coleman 

作者机构：Centre for Public HealthQueen's University BelfastBelfast BT126BAUnited Kingdom Patrick G Johnston Centre for Cancer ResearchQueen's University BelfastBelfast BT71NNUnited Kingdom 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文）)

年 卷 期：2024年第30卷第38期

页      面：4221-4231页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Professor Gary Falk University of Pennsylvania 

主　　题：Early-onset cancer Early-onset oesophageal adenocarcinoma Survival Cancer epidemiology Systematic review Meta-analysis 

摘      要：BACKGROUND The incidence of oesophageal adenocarcinoma(OAC)has been reported to be increasing in many *** this trend,an increase in incidence of early-onset OAC,defined as OAC in adults aged under 50 years,has been *** is unclear whether survival outcomes for early-onset OAC patients differ from older age *** To investigate survival outcomes in early-onset OAC *** Ovid Medline and Embase were searched from inception to January 2022 for relevant studies relating to early-onset OAC and survival *** regarding the overall five-year survival and risk of death of younger and older patients with OAC were extracted and pooled using meta-analyses to produce pooled estimates and 95%CIs where *** Eleven studies which compared survival of early-onset OAC,defined as age at diagnosis of50 years,with older patients were included.A narrative review of median and mean survival demonstrated conflicting results,with studies showing early-onset OAC patients having both better and worse outcomes compared to older age groups.A meta-analysis of five-year survival demonstrated similar outcomes across age groups,with 22%-25%of patients in the young,middle and older age groups alive after five years.A meta-analysis of four studies demon-strated that early-onset OAC patients did not have a significantly increased risk of death compared to middle-aged patients(hazard ratio 1.12,95%CI:0.85-1.47).INTRODUCTION There is concern that the incidence of oesophageal adenocarcinoma(OAC)in patients under 50,described as early-onset OAC,is ***,data regarding survival of younger patients with OAC is ***,while increasing age remains a major non-modifiable risk factor for cancer,the incidence of early-onset cancers,largely accepted to be in adults aged under 50 years,is increasing[1].This includes an observed increase in the incidence of gastrointestinal malignancies such as colorectal,oesophageal,gastric and he