Article Abstract

Clinicopathological features and prognosis of patients <45 years old with esophageal adenocarcinoma comparing to other age groups

Authors: Su Yang, Haibo Li, Chunyi Jia, Xiao Ma, Wei Guo, Hecheng Li


Background: To analyze the clinicopathological features and prognosis of younger patients with esophageal adenocarcinoma (EAC).
Methods: A total of 2,601 patients diagnosed with EAC between 1988 and 2011 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. All patients underwent primary tumor resection and regional lymphadenectomy without preoperative radiotherapy. The patients were into four age groups (<45, 45–59, 60–74, ≥75), with 94, 813, 1,272 and 422 patients in each group respectively.
Results: Patients in the age <45 group were more likely to have lymph node (LN) metastasis (P=0.002), postoperative radiotherapy (P<0.001) and advanced T and N stage (P=0.003, 0.014) compared to the other three groups. We then conducted two Cox proportional hazards model adjusted for the sex, race, number of LNs examined, histological grade, postoperative radiation. The hazard ratio (HR) was higher in patients <45 y and the survival rate were paradoxically lower compared to the patients between 45–60 years old (P=0.046, 0.039).
Conclusions: The patients <45 y had the most aggressive clinicopathological features of EAC and poorer survival rate after radical esophagectomy.