Guo Xinwei, Qin Lang, Yang Rui, Liu Yangchen, Zhou Shaobing, Zhao Weiwei
Department of Radiotherapy, Taixing People's Hospital Affiliated to Yangzhou University, No. 1, Changzheng Road, Taixing City, 225400, Jiangsu Province, China.
Department of Radiotherapy, Huainan Chaoyang Hospital, Huainan, China.
Sci Rep. 2025 Jul 2;15(1):23588. doi: 10.1038/s41598-025-08618-7.
In recent years, the incidence of malignancies among young people, including early-onset esophageal cancer (EOEC), has been increasing globally. This study aims to compare the survival outcomes of metastatic EOEC and late-onset esophageal cancer (LOEC) and to identify prognostic factors. Patient data were collected from the Surveillance, Epidemiology, and End Results database. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using univariate and multivariate Cox regression models. Propensity score matching (PSM) was applied to balance baseline differences. The Kaplan-Meier method and log-rank test were used to compare overall survival (OS). A total of 11,738 cases of metastatic esophageal cancer were included from 2010 to 2020, with 996 EOEC patients and 10,742 LOEC patients. The mean OS for EOEC patients was 14.30 months (95% CI 12.53-16.06 months), compared to 10.89 months (95% CI 10.45-11.33 months) for LOEC patients. Multivariate Cox regression analysis revealed that marital status, histological type, tumor grade, bone metastasis, liver metastasis, surgery, and chemotherapy were independent prognostic factors for EOEC patients (p < 0.05). After adjusting for variables other than age using PSM, the results still indicated better OS for EOEC patients (p = 0.031). Further subgroup analysis showed that chemotherapy primarily influenced survival outcomes in both groups (p = 0.012). Metastatic EOEC showed better OS outcomes compared to LOEC, and EOEC patients benefited more from chemotherapy than LOEC patients.
近年来，包括早发性食管癌（EOEC）在内的年轻人恶性肿瘤发病率在全球范围内呈上升趋势。本研究旨在比较转移性EOEC和晚发性食管癌（LOEC）的生存结局，并确定预后因素。患者数据来自监测、流行病学和最终结果数据库。使用单变量和多变量Cox回归模型计算风险比（HR）和95%置信区间（CI）。应用倾向评分匹配（PSM）来平衡基线差异。采用Kaplan-Meier法和对数秩检验比较总生存期（OS）。2010年至2020年共纳入11738例转移性食管癌病例，其中EOEC患者996例，LOEC患者10742例。EOEC患者的平均OS为14.30个月（95%CI 12.53 - 16.06个月），而LOEC患者为10.89个月（95%CI 10.45 - 11.33个月）。多变量Cox回归分析显示，婚姻状况、组织学类型、肿瘤分级、骨转移、肝转移、手术和化疗是EOEC患者的独立预后因素（p < 0.05）。使用PSM对年龄以外的变量进行调整后，结果仍显示EOEC患者的OS更好（p = 0.031）。进一步的亚组分析表明，化疗主要影响两组的生存结局（p = 0.012）。与LOEC相比，转移性EOEC的OS结局更好，且EOEC患者比LOEC患者从化疗中获益更多。
