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Clinical characteristics and prognostic outcomes for adenocarcinoma of esophagogastric junction in early-onset patients: a population-based appraisal

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Abstract

Purpose

Malignancies of the upper gastrointestinal tract are rare in early-onset patients outside the hereditary genetic disorders. There are few reports describing adenocarcinoma of the esophagogastric junction (AEG) in extremely early-onset patients aged under 50 years old. The aim of this study was to describe the clinicopathological features and prognosis of adenocarcinoma of esophagogastric junction (AEG) in early-onset patients among three successive periods: 1975–1989 (period 1), 1990–2004 (period 2), and 2005–2017 (period 3).

Methods

Between 1975 and 2017, data were extracted from the Surveillance, Epidemiology, and End Results database, and 18,278 patients with AEG were enrolled. Three age groups of patients were identified: < 50, 50–69, and ≥ 70 years of age. Clinicopathological characteristics and prognostic outcomes were reviewed and compared among three groups over three periods (1975–89, 1990–04, and 2005–2017). Multivariate Cox regression analysis was performed to adjust for covariate effects related to both overall survival (OS) and cancer-specific survival (CSS).

Results

Among three age groups, early-onset patients were more likely to present with higher tumor grade, advanced nodal, and distant metastatic disease at diagnosis than other groups (p < 0.01 for both). In comparison to the older group, a higher proportion of patients in the early-onset group received chemotherapy and radiation treatment. After adjusting for covariates, early-onset patients had a better CSS and OS than elderly patients.

Conclusions

Early-onset AEG patients were more likely than other age groups to present with advanced disease upon diagnosis. However, the prognosis of early-onset patients was better than their older counterparts after adjustment for covariates. The dissimilarities in tolerance to treatment among early-onset, middle-aged, and elderly patients could be the reason for this difference.

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Availability of data and materials

The datasets generated and analyzed during the current study are publicly available.

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Funding

This study was funded by Guangdong Medical Scientific Research Foundation, (B2022168); Natural Science Foundation of Guangdong Provincial of China (2020A1515010573); National key Clinical Specialty Construction Project (2021–2024, No. 2022YW030009).

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Author notes

  1. Hongkun Lai, Jiabin Zheng and Guinan Zhou contributed equally to this work.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, Guangdong, People’s Republic of China

    Hongkun Lai, Jiabin Zheng, Guinan Zhou & Yong Li

  2. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, People’s Republic of China

    Hongkun Lai, Jiabin Zheng & Yong Li

Authors
  1. Hongkun Lai
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  2. Jiabin Zheng
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  3. Guinan Zhou
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  4. Yong Li
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Contributions

All authors have helped in performing this research; Conception and design: HL, JZ, GZ, YL. Collection and assembly of data: HL, JZ, GZ. Data analysis and interpretation: HL, JZ. Manuscript writing: all authors. Final approval of the manuscript: all authors.

Corresponding author

Correspondence to Yong Li.

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Lai, H., Zheng, J., Zhou, G. et al. Clinical characteristics and prognostic outcomes for adenocarcinoma of esophagogastric junction in early-onset patients: a population-based appraisal. J Cancer Res Clin Oncol 149, 14941–14952 (2023). https://doi.org/10.1007/s00432-023-05210-2

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  • DOI: https://doi.org/10.1007/s00432-023-05210-2

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