Abstract：
BACKGROUND: Colorectal cancer (CRC) is a major global health concern, with a rising incidence in young individuals. Early-onset CRC displays unique clinicopathological and molecular characteristics, necessitating a closer examination of prognosis, particularly in the context of adjuvant chemotherapy. This study aimed to investigate the prognosis of early-onset CRC patients (< 50 years) diagnosed at stage II/III compared to older counterparts, utilizing propensity score matching to minimize heterogeneity.
METHODS: A retrospective analysis of 3324 stage II/III CRC patients aged < 70 years was conducted, focusing on age-based subgroups (< 50 vs. ≥ 50 years). Propensity score matching balanced clinical characteristics. Relapse-free survival (RFS) and overall survival (OS) were analyzed.
RESULTS: In stage II CRC, age of onset did not impact prognosis after adjuvant chemotherapy, with no significant differences in RFS (5-year RFS rates: 80% in both groups, p = 0.98) and OS (5-year OS rates: 96% vs. 92%, p = 0.17). In stage III, a trend suggested slightly poorer OS in patients aged < 50 years than those ≥ 50 years (5-year OS rates: 85% vs. 88%, p = 0.077). However, in a propensity score-matched cohort, age-dependent differences were attenuated (5-year OS rates: 85% vs. 88%, p = 0.32).
CONCLUSIONS: In the context of stage II/III CRC patients receiving adjuvant chemotherapy, age was not an independent predictor of prognosis. Age alone should not be the sole factor guiding treatment decisions.
METHODS: A retrospective analysis of 3324 stage II/III CRC patients aged < 70 years was conducted, focusing on age-based subgroups (< 50 vs. ≥ 50 years). Propensity score matching balanced clinical characteristics. Relapse-free survival (RFS) and overall survival (OS) were analyzed.
RESULTS: In stage II CRC, age of onset did not impact prognosis after adjuvant chemotherapy, with no significant differences in RFS (5-year RFS rates: 80% in both groups, p = 0.98) and OS (5-year OS rates: 96% vs. 92%, p = 0.17). In stage III, a trend suggested slightly poorer OS in patients aged < 50 years than those ≥ 50 years (5-year OS rates: 85% vs. 88%, p = 0.077). However, in a propensity score-matched cohort, age-dependent differences were attenuated (5-year OS rates: 85% vs. 88%, p = 0.32).
CONCLUSIONS: In the context of stage II/III CRC patients receiving adjuvant chemotherapy, age was not an independent predictor of prognosis. Age alone should not be the sole factor guiding treatment decisions.
摘要：
背景：结直肠癌（CRC）是全球主要的健康问题，年轻人的发病率上升。早发型CRC表现出独特的临床病理和分子特征,需要更仔细地检查预后，特别是在辅助化疗的背景下。本研究旨在调查诊断为II/III期的早发性CRC患者（<50岁）与老年患者相比的预后。利用倾向得分匹配来最小化异质性。
方法：对3324例年龄<70岁的II/III期CRC患者进行回顾性分析，侧重于基于年龄的亚组(<50vs.≥50年)。倾向评分匹配平衡的临床特征。分析无复发生存期(RFS)和总生存期(OS)。
结果：在第二阶段CRC中，发病年龄不影响辅助化疗后的预后，RFS无显著差异(5年RFS率：两组均为80%，p=0.98）和OS（5年OS率：96%与92%,p=0.17）。在第三阶段,趋势表明，年龄<50岁的患者的OS比年龄≥50岁的患者稍差（5年OS率：85％vs.88%,p=0.077)。然而,在倾向得分匹配的队列中，年龄依赖性差异减弱(5年OS率：85%vs.88%,p=0.32）。
结论：在II/III期CRC患者接受辅助化疗的情况下，年龄不是预后的独立预测因子.仅年龄不应成为指导治疗决定的唯一因素。
方法：对3324例年龄<70岁的II/III期CRC患者进行回顾性分析，侧重于基于年龄的亚组(<50vs.≥50年)。倾向评分匹配平衡的临床特征。分析无复发生存期(RFS)和总生存期(OS)。
结果：在第二阶段CRC中，发病年龄不影响辅助化疗后的预后，RFS无显著差异(5年RFS率：两组均为80%，p=0.98）和OS（5年OS率：96%与92%,p=0.17）。在第三阶段,趋势表明，年龄<50岁的患者的OS比年龄≥50岁的患者稍差（5年OS率：85％vs.88%,p=0.077)。然而,在倾向得分匹配的队列中，年龄依赖性差异减弱(5年OS率：85%vs.88%,p=0.32）。
结论：在II/III期CRC患者接受辅助化疗的情况下，年龄不是预后的独立预测因子.仅年龄不应成为指导治疗决定的唯一因素。
