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Meta-Analysis
. 2024 Oct 14;30(38):4221-4231.
doi: 10.3748/wjg.v30.i38.4221.

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

Ashleigh Russell  1 , Shauna Mitchell  2 , Richard C Turkington  2 , Helen G Coleman  3
Affiliations
Meta-Analysis

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

Ashleigh Russell et al. World J Gastroenterol. .

Abstract

Background: The incidence of oesophageal adenocarcinoma (OAC) has been reported to be increasing in many countries. Alongside this trend, an increase in incidence of early-onset OAC, defined as OAC in adults aged under 50 years, has been observed. It is unclear whether survival outcomes for early-onset OAC patients differ from older age groups.

Aim: To investigate survival outcomes in early-onset OAC patients.

Methods: Ovid Medline and Embase were searched from inception to January 2022 for relevant studies relating to early-onset OAC and survival outcomes. Results 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 possible.

Results: Eleven studies which compared survival of early-onset OAC, defined as age at diagnosis of < 50 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 demonstrated 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).

Conclusion: Results suggest that early-onset OAC patients do not have a significantly different survival compared to older patients, but further population-based research, taking into account stage and treatment, is required.

Keywords: Cancer epidemiology; Early-onset cancer; Early-onset oesophageal adenocarcinoma; Meta-analysis; Survival; Systematic review.

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Conflict of interest statement

Conflict-of-interest statement: Payment or honoraria for lectures, presentations, or educational events: Dr. Ashleigh Russell (née Hamilton): Bristol-Myers Squibb (independent Speaker - paid directly by BMS).

Figures

Figure 1
Figure 1
Flow chart of the selected articles included in the review.
Figure 2
Figure 2
Forest plots. A: Forest plots showing overall five-year survival of young, middle-aged, and older patients diagnosed with oesophageal adenocarcinoma (with effect size being the proportion of patients alive); B: Risk of death in adults diagnosed with early-onset oesophageal adenocarcinoma compared with older adults.
See this image and copyright information in PMC

References

    1. Zhao J, Xu L, Sun J, Song M, Wang L, Yuan S, Zhu Y, Wan Z, Larsson S, Tsilidis K, Dunlop M, Campbell H, Rudan I, Song P, Theodoratou E, Ding K, Li X. Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019. BMJ Oncol. 2023;2:e000049.
    1. Ben-Aharon I, van Laarhoven HWM, Fontana E, Obermannova R, Nilsson M, Lordick F. Early-Onset Cancer in the Gastrointestinal Tract Is on the Rise-Evidence and Implications. Cancer Discov. 2023;13:538–551. - PubMed
    1. Islami F, DeSantis CE, Jemal A. Incidence Trends of Esophageal and Gastric Cancer Subtypes by Race, Ethnicity, and Age in the United States, 1997-2014. Clin Gastroenterol Hepatol. 2019;17:429–439. - PubMed
    1. Siegel RL, Torre LA, Soerjomataram I, Hayes RB, Bray F, Weber TK, Jemal A. Global patterns and trends in colorectal cancer incidence in young adults. Gut. 2019;68:2179–2185. - PubMed
    1. Abnet CC, Arnold M, Wei WQ. Epidemiology of Esophageal Squamous Cell Carcinoma. Gastroenterology. 2018;154:360–373. - PMC - PubMed

Supplementary concepts