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

Ashleigh Russell*, Shauna Mitchell, Richard C. Turkington, Helen G. Coleman

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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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.

Original languageEnglish
Pages (from-to)4221-4231
Number of pages11
JournalWorld Journal of Gastroenterology
Volume30
Issue number38
DOIs
Publication statusPublished - 14 Oct 2024

Bibliographical note

Publisher Copyright:
©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.

Keywords

  • Cancer epidemiology
  • Early-onset cancer
  • Early-onset oesophageal adenocarcinoma
  • Meta-analysis
  • Survival
  • Systematic review

ASJC Scopus subject areas

  • Gastroenterology

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