Russell A, Mitchell S, Turkington RC, Coleman HG. Survival outcomes in early-onset oesophageal adenocarcinoma patients: A systematic review and meta-analyses. World J Gastroenterol 2024; 30(38): 4221-4231 [PMID: 39493329 DOI: 10.3748/wjg.v30.i38.4221]
Corresponding Author of This Article
Ashleigh Russell, MBChB, MRCP, PhD, Academic Fellow, Staff Physician, Centre for Public Health, Queen's University Belfast, ICS-B Building, Royal Victoria Hospital Site, Grosvenor Road, Belfast BT12 6BA, United Kingdom. a.russell@qub.ac.uk
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 14, 2024; 30(38): 4221-4231 Published online Oct 14, 2024. doi: 10.3748/wjg.v30.i38.4221
Survival outcomes in early-onset oesophageal adenocarcinoma patients: A systematic review and meta-analyses
Ashleigh Russell, Shauna Mitchell, Richard C Turkington, Helen G Coleman
Ashleigh Russell, Helen G Coleman, Centre for Public Health, Queen's University Belfast, Belfast BT12 6BA, United Kingdom
Shauna Mitchell, Richard C Turkington, Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
Author contributions: Mitchell S, Coleman HG and Turkington RC designed the research; Mitchell S, Coleman HG and Turkington RC performed the research; All authors contributed to data analysis and interpretation, and writing of the paper.
Conflict-of-interest statement: Payment or honoraria for lectures, presentations, or educational events: Dr. Ashleigh Russell (née Hamilton): Bristol-Myers Squibb (independent Speaker - paid directly by BMS).
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2020 Checklist, and the manuscript was prepared and revised according to the PRISMA 2020 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ashleigh Russell, MBChB, MRCP, PhD, Academic Fellow, Staff Physician, Centre for Public Health, Queen's University Belfast, ICS-B Building, Royal Victoria Hospital Site, Grosvenor Road, Belfast BT12 6BA, United Kingdom. a.russell@qub.ac.uk
Received: January 28, 2024 Revised: July 4, 2024 Accepted: September 20, 2024 Published online: October 14, 2024 Processing time: 245 Days and 9.3 Hours
Abstract
BACKGROUND
The incidence of oesophageal adenocarcinoma (OAC) has been reported to be increasing in many countries. Alongside this trend, an increase in incidence of early-onset OAC, defined as OAC in adults aged under 50 years, has been observed. It is unclear whether survival outcomes for early-onset OAC patients differ from older age groups.
AIM
To investigate survival outcomes in early-onset OAC patients.
METHODS
Ovid Medline and Embase were searched from inception to January 2022 for relevant studies relating to early-onset OAC and survival outcomes. Results regarding the overall five-year survival and risk of death of younger and older patients with OAC were extracted and pooled using meta-analyses to produce pooled estimates and 95%CIs where possible.
RESULTS
Eleven studies which compared survival of early-onset OAC, defined as age at diagnosis of < 50 years, with older patients were included. A narrative review of median and mean survival demonstrated conflicting results, with studies showing early-onset OAC patients having both better and worse outcomes compared to older age groups. A meta-analysis of five-year survival demonstrated similar outcomes across age groups, with 22%-25% of patients in the young, middle and older age groups alive after five years. A meta-analysis of four studies demonstrated that early-onset OAC patients did not have a significantly increased risk of death compared to middle-aged patients (hazard ratio 1.12, 95%CI: 0.85-1.47).
CONCLUSION
Results suggest that early-onset OAC patients do not have a significantly different survival compared to older patients, but further population-based research, taking into account stage and treatment, is required.
Core Tip: In this systematic review, we investigated survival outcomes in early-onset oesophageal adenocarcinoma (OAC) (< 50 years) compared to older age groups. Eleven studies were included. A narrative review of median and mean survival demonstrated conflicting results. Meta-analyses of 5-year survival and risk of death demonstrated no significant difference in survival between younger and older OAC patients. Current evidence in this area has limitations, and up-to-date population-based research is required.
