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Clinical and molecular characteristics of early-onset vs average-onset esophagogastric cancer.
- Source :
-
Journal of the National Cancer Institute [J Natl Cancer Inst] 2024 Feb 08; Vol. 116 (2), pp. 299-308. - Publication Year :
- 2024
-
Abstract
- Background: The rate of esophagogastric cancer is rising among individuals under 50 years of age. It remains unknown whether early-onset esophagogastric cancer represents a unique entity. This study investigated the clinical and molecular characteristics of early-onset and average-onset esophagogastric cancer .<br />Methods: We reviewed the Memorial Sloan Kettering Cancer Center gastric, esophageal, and gastroesophageal junction cancer database. Associations between baseline characteristics and tumor and germline molecular alterations were compared between those with early-onset and average-onset esophagogastric cancer using Fisher exact tests and the Benjamini-Hochberg method for multiple-hypothesis correction.<br />Results: We included 1123 patients with early-onset esophagogastric cancer (n = 219; median age = 43 years [range = 18-49 years]) and average-onset esophagogastric cancer (n = 904; median age = 67 years [range = 50-94 years]) treated between 2005 and 2018. The early-onset group had more women (39% vs 28%, P = .002). Patients with early-onset esophagogastric cancer were more likely to have a gastric primary site (64% vs 44%, P < .0001). The signet ring cell and/or diffuse type was 3 times more common in the early-onset esophagogastric cancer group (31% vs 9%, P < .0001). Early-onsite tumors were more frequently genomically stable (31% vs 18%, P = .0002) and unlikely to be microsatellite instability high (2% vs 7%, P = .003). After restricting to adenocarcinoma and signet ring cell and/or diffuse type carcinomas, we observed no difference in stage (P = .40) or overall survival from stage IV diagnosis (median = 22.7 vs 22.1 months, P = .78).<br />Conclusions: Our study supported a preponderance of gastric primary disease sites, signet ring histology, and genomically stable molecular subtypes in early-onset esophagogastric cancer. Our findings highlight the need for further research to define the underlying pathogenesis and strategies for early detection and prevention.<br /> (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Humans
Female
Adolescent
Young Adult
Adult
Middle Aged
Aged
Aged, 80 and over
Cardia metabolism
Esophagogastric Junction metabolism
Esophagogastric Junction pathology
Retrospective Studies
Esophageal Neoplasms epidemiology
Esophageal Neoplasms genetics
Stomach Neoplasms diagnosis
Stomach Neoplasms epidemiology
Stomach Neoplasms genetics
Adenocarcinoma epidemiology
Adenocarcinoma genetics
Carcinoma, Signet Ring Cell metabolism
Carcinoma, Signet Ring Cell pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2105
- Volume :
- 116
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of the National Cancer Institute
- Publication Type :
- Academic Journal
- Accession number :
- 37699004
- Full Text :
- https://doi.org/10.1093/jnci/djad186