Su Yang1, Haibo Li2, Chunyi Jia3, Xiao Ma4, Wei Guo4, Hecheng Li1. 1. Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. 2. School of Public Health, Wannan Medical College, Wuhu 241002, China. 3. The 2nd Department of Thoracic Surgery, Jilin Province Cancer Hospital, Changchun 130012, China. 4. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.
Abstract
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.
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.
Entities:
Keywords:
Esophageal adenocarcinoma (EAC); prognosis; the Surveillance, Epidemiology, and End Results (SEER); young patients
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