METHODS: Data on patient characteristics, tumor characteristics, incidence, and mortality were obtained from the SEER database from 2010 to 2020. We identified 23,278 individuals aged > 18 years with a confirmed diagnosis of all histological subtypes of metastatic CRC (M1 on TNM stage) using ICD-O-3 site codes. mEO-CRC and mAO-CRC were compared. OS distributions and CCS were analyzed using the Kaplan-Meier method and log-rank test to assess differences. A Cox regression model was used to assess the associations between variables.
RESULTS: mEO-CRC constituted 17.79% of the cases, whereas 82.21% had mAO-CRC. Most patients with mEO-CRC were 45-49 years old (47.66%), male (52.16%) and White (72.57%) and had adenocarcinoma histology (87.30%). Left colon tumors were most prevalent in both groups (40.26%) but were more prevalent in mEO-CRC patients than in mAO-CRC patients (49.63% vs. 38.23%, p < 0.001). Patients with mEO-CRC had higher OS (p < 0.001) and CSS (p < 0.001) than those with mAO-CRC. Patients with mEO-CRC also had significantly better median overall survival (30 months vs. 18 months, p < 0.001). The factors associated with worse OS included mAO-CRC (p < 0.001), mucinous adenocarcinoma (p < 0.001), male sex (p = 0.003), and a lack of surgical intervention (p < 0.001).
CONCLUSIONS: Most patients with mEO-CRC fall within the range of 45 to 49 years of age. Patients with mEO-CRC were more likely to receive cancer-directed therapy (including chemotherapy and radiotherapy) and had better OS and CSS than those with mAO-CRC. This is likely attributable to the better performance status, fewer comorbidities, and better tolerance to cancer-directed therapy in mEO-CRC patients. The factors associated with worse OS and CSS were age > 50 years, mucinous adenocarcinoma, male sex, and no surgical treatment.
方法:患者特征数据,肿瘤特征,发病率,和死亡率从2010年至2020年的SEER数据库获得。我们使用ICD-O-3位点代码鉴定了23,278名年龄>18岁的个体,并确认了转移性CRC的所有组织学亚型(TNM期M1)。比较mEO-CRC和mAO-CRC。使用Kaplan-Meier方法和对数秩检验分析OS分布和CCS以评估差异。使用Cox回归模型来评估变量之间的关联。
结果:mEO-CRC占病例的17.79%,而有MAO-CRC的占82.21%。大多数mEO-CRC患者年龄为45-49岁(47.66%),男性(52.16%)和白人(72.57%),有腺癌组织学(87.30%)。左结肠肿瘤在两组中最普遍(40.26%),但在mEO-CRC患者中比在mAO-CRC患者中更普遍(49.63%vs.38.23%,p<0.001)。mEO-CRC患者的OS(p<0.001)和CSS(p<0.001)高于mAO-CRC患者。患有mEO-CRC的患者的中位总生存期也明显更好(30个月vs.18个月,p<0.001)。与OS较差相关的因素包括MAO-CRC(p<0.001),黏液腺癌(p<0.001),男性(p=0.003),缺乏手术干预(p<0.001)。
结论:大多数mEO-CRC患者的年龄范围为45至49岁。与MAO-CRC患者相比,MEO-CRC患者更有可能接受癌症定向治疗(包括化疗和放疗),并且OS和CSS更好。这可能归因于更好的性能状态,减少合并症,mEO-CRC患者对癌症定向治疗的耐受性更好。与OS和CSS较差相关的因素是年龄>50岁,黏液腺癌,男性,也没有手术治疗.