Treatment Variation Impacts Survival Among Patients With Early-Onset Metastatic Colorectal Cancer

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2026-09-28 Epub Date: 2026-07-15 DOI:10.1002/jso.70340

George Q. Zhang, Ezra S. Brooks, Nelya Melnitchouk, Jennifer L. Irani, Ronald Bleday, Joel E. Goldberg

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引用次数: 0

Abstract

Background and Objectives

The incidence of early-onset colorectal cancer (eoCRC) is rising, yet optimal management in the metastatic setting remains unclear. We characterized and compared treatment patterns among patients with early-onset and later-onset (loCRC) metastatic CRC, and evaluated outcomes by treatment regimen among patients with eoCRC.

Methods

We performed a retrospective analysis of patients diagnosed with stage IV CRC between 2004 and 2022. Patients were stratified by age (eoCRC, < 50 years; loCRC, 50–59.9 [reference], 60–69.9, and ≥ 70). Utilization of systemic chemotherapy (CT), primary resection (PR), immunotherapy (IO), and metastasis resection (MR) were compared across age groups. Among patients with eoCRC, overall survival was compared by treatment regimen.

Results

Among 259,435 patients with stage IV CRC, 15.6% were classified as eoCRC. Compared with patients with loCRC, those with eoCRC were more likely to undergo multimodal treatment regimens including CT/PR, CT/PR/MR, and CT/PR/IO (p < 0.05 for all). Among patients with eoCRC, CT/PR (adjusted HR 0.49, 95% CI 0.47–0.51), CT/PR/MR (HR 0.36, 95% CI 0.34–0.38), and CT/PR/IO (HR 0.52, 95% CI 0.49–0.55) were associated with the greatest survival benefit, versus CT alone.

Conclusions

Patients with metastatic eoCRC more frequently received aggressive, multimodal therapy, which was associated with improved survival.

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治疗变化影响早发性转移性结直肠癌患者的生存。

背景和目的：早发性结直肠癌（eoCRC）的发病率正在上升，但在转移性情况下的最佳治疗仍不清楚。我们描述并比较了早发性和晚发性（loCRC）转移性结直肠癌患者的治疗模式，并通过治疗方案评估了eoCRC患者的预后。方法：我们对2004年至2022年间诊断为IV期CRC的患者进行了回顾性分析。结果：在259,435例IV期CRC患者中，15.6%被归类为eoCRC。与原位crc患者相比，eoCRC患者更有可能接受多模式治疗方案，包括CT/PR、CT/PR/MR和CT/PR/IO (p结论：转移性eoCRC患者更频繁地接受积极的多模式治疗，这与生存率提高有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.