Centre for Public Health, Queen's University Belfast, Belfast BT12 6BA, United Kingdom.
Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast BT7 1NN, United Kingdom.
World J Gastroenterol. 2024 Oct 14;30(38):4221-4231. doi: 10.3748/wjg.v30.i38.4221.
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.
To investigate survival outcomes in early-onset OAC patients.
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.
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).
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.
食管腺癌（OAC）的发病率在许多国家都有所上升。随着这一趋势，早发性 OAC 的发病率也有所上升，早发性 OAC 定义为 50 岁以下成年人的 OAC。目前尚不清楚早发性 OAC 患者的生存结局是否与年龄较大的患者不同。
研究早发性 OAC 患者的生存结局。
从 Ovid Medline 和 Embase 数据库中检索了从建库至 2022 年 1 月与早发性 OAC 及生存结局相关的研究。提取了关于年轻和年长 OAC 患者总体五年生存率和死亡风险的结果，并使用荟萃分析对其进行了汇总，以生成汇总估计值和 95%CI（在可能的情况下）。
共纳入了 11 项比较早发性 OAC（定义为诊断时年龄<50 岁）与年长患者生存结局的研究。对中位生存和平均生存的叙述性综述结果存在差异，研究表明早发性 OAC 患者的生存结局好于或差于年长患者。对五年生存率的荟萃分析显示，各年龄组的生存结局相似，年轻、中年和老年组中有 22%-25%的患者在五年后仍然存活。对四项研究的荟萃分析表明，早发性 OAC 患者的死亡风险与中年患者相比没有显著增加（风险比 1.12，95%CI：0.85-1.47）。
结果表明，早发性 OAC 患者的生存结局与年长患者无显著差异，但需要进一步进行基于人群的研究，考虑分期和治疗因素。
