Marla Lipsyc-Sharf1, Sui Zhang2, Fang-Shu Ou3, Chao Ma1, Nadine Jackson McCleary1, Donna Niedzwiecki4, I-Wen Chang5, Heinz-Josef Lenz6, Charles D Blanke7, Sorbarikor Piawah8, Katherine Van Loon8, Tiffany M Bainter3, Alan P Venook8, Robert J Mayer1, Charles S Fuchs9,10, Federico Innocenti11, Andrew B Nixon12, Richard Goldberg13, Eileen M O'Reilly14, Jeffrey A Meyerhardt1, Kimmie Ng1. 1. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. 2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 3. Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA. 4. Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Duke University, Durham, NC, USA. 5. Southeast Clinical Oncology Research (SCOR) Consortium, Winston-Salem, NC, USA. 6. Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 7. SWOG Group Chair's Office/Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA. 8. Department of Medicine, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA. 9. Yale Cancer Center and Smilow Cancer Hospital, New Haven, CT, USA. 10. Genentech, South San Francisco, CA, USA. 11. Eshelman School of Pharmacy and Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 12. Duke Cancer Institute, Duke University, Durham, NC, USA. 13. West Virginia University Cancer Institute, Morgantown, WV, USA. 14. Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA.
Abstract
BACKGROUND: The incidence of young-onset colorectal cancer (yoCRC) is increasing. It is unknown if there are survival differences between young and older patients with metastatic colorectal cancer (mCRC). METHODS: We studied the association of age with survival in 2326 mCRC patients enrolled in the Cancer and Leukemia Group B and SWOG 80405 trial, a multicenter, randomized trial of first-line chemotherapy plus biologics. The primary and secondary outcomes of this study were overall survival (OS) and progression-free survival (PFS), respectively, which were assessed by Kaplan-Meier method and compared among younger vs older patients with the log-rank test. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated based on Cox proportional hazards modeling, adjusting for known prognostic variables. All statistical tests were 2-sided. RESULTS: Of 2326 eligible subjects, 514 (22.1%) were younger than age 50 years at study entry (yoCRC cohort). The median age of yoCRC patients was 44.3 vs 62.5 years in patients aged 50 years and older. There was no statistically significant difference in OS between yoCRC vs older-onset patients (median = 27.07 vs 26.12 months; adjusted HR = 0.98, 95% CI = 0.88 to 1.10; P = .78). The median PFS was also similar in yoCRC vs older patients (10.87 vs 10.55 months) with an adjusted hazard ratio of 1.02 (95% CI = 0.92 to 1.13; P = .67). Patients younger than age 35 years had the shortest OS with median OS of 21.95 vs 26.12 months in older-onset patients with an adjusted hazard ratio of 1.08 (95% CI = 0.81 to 1.44; Ptrend = .93). CONCLUSION: In this large study of mCRC patients, there were no statistically significant differences in survival between patients with yoCRC and CRC patients aged 50 years and older.
BACKGROUND: The incidence of young-onset colorectal cancer (yoCRC) is increasing. It is unknown if there are survival differences between young and older patients with metastatic colorectal cancer (mCRC). METHODS: We studied the association of age with survival in 2326 mCRC patients enrolled in the Cancer and Leukemia Group B and SWOG 80405 trial, a multicenter, randomized trial of first-line chemotherapy plus biologics. The primary and secondary outcomes of this study were overall survival (OS) and progression-free survival (PFS), respectively, which were assessed by Kaplan-Meier method and compared among younger vs older patients with the log-rank test. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated based on Cox proportional hazards modeling, adjusting for known prognostic variables. All statistical tests were 2-sided. RESULTS: Of 2326 eligible subjects, 514 (22.1%) were younger than age 50 years at study entry (yoCRC cohort). The median age of yoCRC patients was 44.3 vs 62.5 years in patients aged 50 years and older. There was no statistically significant difference in OS between yoCRC vs older-onset patients (median = 27.07 vs 26.12 months; adjusted HR = 0.98, 95% CI = 0.88 to 1.10; P = .78). The median PFS was also similar in yoCRC vs older patients (10.87 vs 10.55 months) with an adjusted hazard ratio of 1.02 (95% CI = 0.92 to 1.13; P = .67). Patients younger than age 35 years had the shortest OS with median OS of 21.95 vs 26.12 months in older-onset patients with an adjusted hazard ratio of 1.08 (95% CI = 0.81 to 1.44; Ptrend = .93). CONCLUSION: In this large study of mCRC patients, there were no statistically significant differences in survival between patients with yoCRC and CRC patients aged 50 years and older.
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