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Background <p>Gastroesophageal cancer presents variably across different age groups, with early-onset (EO) cases showing distinct pathological and clinical characteristics compared to late-onset (LO) disease. This study aims to delineate these differences and assess treatment outcomes in a Central European population.</p> Methods <p>Data from patients diagnosed with gastroesophageal carcinoma and treated between 2010 and 2022, at a high-volume comprehensive cancer center representing approximately 5% of all national gastroesophageal cancer cases in the Czech Republic, were retrospectively analyzed. Patients were categorized into EO (&lt; 50 years) and LO (≥ 50 years) groups. Clinicopathological characteristics were compared in the entire cohort, while treatment patterns and survival outcomes were evaluated in patients with adenocarcinoma.</p> Results <p>A total of 1,377 patients were included, with 161 (11.7%) classified as EO. EO patients are more frequently present with ECOG performance status 0 (42%), lower BMI, current smoking (44%), gastric cancer primaries (63%), and aggressive tumor characteristics such as poorly cohesive adenocarcinoma subtype (45%) and metastatic disease (55%). Hereditary cancer syndrome was confirmed in 4.3% of EO cases. Among adenocarcinoma patients, triplet chemotherapy was more frequently used in the EO group (29% vs. 11%, <i>p</i> &lt; 0.001) in the first-line setting. However, no significant survival benefit was observed in inoperable or metastatic disease (median overall survival 9.1 vs. 9.6 months in EO and LO, respectively, <i>p</i> = 0.913).</p> Conclusions <p>EO gastroesophageal cancer in the Central European population is associated with distinct clinicopathological characteristics, with no significant impact on survival.</p> Miniabstract <p>This study identifies distinct clinicopathological characteristics in early-onset gastroesophageal cancer in Central Europe, characterized by more aggressive attributes but without significant survival differences compared to late-onset cases.</p>

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Early- versus late-onset gastroesophageal cancer: real-world outcomes from a 13-year central European cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月27日

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  • Tomas Sokop,
  • Iveta Selingerova,
  • Vaclav Jedlicka,
  • Lumir Kunovsky,
  • Igor Kiss,
  • Radka Lordick Obermannova

摘要

Background

Gastroesophageal cancer presents variably across different age groups, with early-onset (EO) cases showing distinct pathological and clinical characteristics compared to late-onset (LO) disease. This study aims to delineate these differences and assess treatment outcomes in a Central European population.

Methods

Data from patients diagnosed with gastroesophageal carcinoma and treated between 2010 and 2022, at a high-volume comprehensive cancer center representing approximately 5% of all national gastroesophageal cancer cases in the Czech Republic, were retrospectively analyzed. Patients were categorized into EO (< 50 years) and LO (≥ 50 years) groups. Clinicopathological characteristics were compared in the entire cohort, while treatment patterns and survival outcomes were evaluated in patients with adenocarcinoma.

Results

A total of 1,377 patients were included, with 161 (11.7%) classified as EO. EO patients are more frequently present with ECOG performance status 0 (42%), lower BMI, current smoking (44%), gastric cancer primaries (63%), and aggressive tumor characteristics such as poorly cohesive adenocarcinoma subtype (45%) and metastatic disease (55%). Hereditary cancer syndrome was confirmed in 4.3% of EO cases. Among adenocarcinoma patients, triplet chemotherapy was more frequently used in the EO group (29% vs. 11%, p < 0.001) in the first-line setting. However, no significant survival benefit was observed in inoperable or metastatic disease (median overall survival 9.1 vs. 9.6 months in EO and LO, respectively, p = 0.913).

Conclusions

EO gastroesophageal cancer in the Central European population is associated with distinct clinicopathological characteristics, with no significant impact on survival.

Miniabstract

This study identifies distinct clinicopathological characteristics in early-onset gastroesophageal cancer in Central Europe, characterized by more aggressive attributes but without significant survival differences compared to late-onset cases.