Pretta Andrea, Ziranu Pina, Perissinotto Eleonora, Ghelardi Filippo, Marmorino Federica, Giampieri Riccardo, Puci Mariangela, De Grandis Maria Caterina, Lai Eleonora, Nasca Vincenzo, Ciraci Paolo, Puzzoni Marco, Cerma Krisida, Sciortino Carolina, Taravella Ada, Pretta Gianluca, Giuliani Lorenzo, Damonte Camilla, Pusceddu Valeria, Sotgiu Giovanni, Berardi Rossana, Lonardi Sara, Bergamo Francesca, Pietrantonio Filippo, Cremolini Chiara, Scartozzi Mario
Medical Oncology Unit, University Hospital and University of Cagliari, Cagliari, Italy.
Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padova, Italy.
Br J Cancer. 2025 Feb;132(2):188-194. doi: 10.1038/s41416-024-02902-5. Epub 2024 Nov 27.
Despite a reduction of both incidence and mortality from CRC, recent studies have shown an increase in the incidence of early-onset CRC (EO-CRC). Data on this setting are limited. The aim of our study was to evaluate the clinical and molecular profiles of metastatic EO-CRC patients in order to identify differences compared to a late-onset CRC (LO-CRC) control group.
We retrospectively collected data from 1272 metastatic colorectal cancers from 5 different Italian Institutions. The main objective was to the evaluate clinical outcome for EO-CRC patients in comparison to patients included in the control group.
In the overall population, mOS was 34,7 in EO-CRC pts vs 43,0 months (mo) (p < 0,0001). In the RAS/BRAF mutated subgroup mOS in EO-CRC pts was 30,3 vs 34,0 mo (p = 0,0156). In RAS/BRAF wild-type EO-CRC mOS was 43,0 vs 50,0 mo (p = 0,0290). mPFS was 11,0 in EO-CRC pts vs 14,0 mo (p < 0,0001).
Findings indicate a general worse prognosis for patients with early-onset colorectal cancer compared to late-onset patients. Interestingly this seems to occur regardless of the molecular status. These observations might have a considerable impact on clinical practice and research.
尽管结直肠癌的发病率和死亡率均有所下降，但最近的研究表明早发性结直肠癌（EO-CRC）的发病率有所上升。关于这种情况的数据有限。我们研究的目的是评估转移性EO-CRC患者的临床和分子特征，以便确定与晚发性结直肠癌（LO-CRC）对照组相比的差异。
我们回顾性收集了来自5个不同意大利机构的1272例转移性结直肠癌的数据。主要目的是评估EO-CRC患者与对照组患者的临床结局。
在总体人群中，EO-CRC患者的总生存期（mOS）为34.7个月，而对照组为43.0个月（p<0.0001）。在RAS/BRAF突变亚组中，EO-CRC患者的mOS为30.3个月，而对照组为34.0个月（p=0.0156）。在RAS/BRAF野生型EO-CRC中，mOS为43.0个月，而对照组为50.0个月（p=0.0290）。EO-CRC患者的无进展生存期（mPFS）为11.0个月, 而对照组为14.0个月（p<0.0001）。
研究结果表明，与晚发性患者相比，早发性结直肠癌患者的总体预后更差。有趣的是，无论分子状态如何，似乎都是如此。这些观察结果可能会对临床实践和研究产生重大影响。
