Clinical characteristics and survival in early-onset lung cancer: a multicenter cohort study

Early-onset Pancreatic Cancer is Associated With Better Survival: A SEER Population-Based Analysis.

OBJECTIVES The incidence of early-onset pancreatic cancer is increasing worldwide. This study aimed to evaluate whether survival differences between early and late-onset pancreatic cancer persist after adjustment for tumor characteristics, stage at diagnosis, and treatment, including within stage and treatment-specific subgroups. METHODS This retrospective SEER cohort study included patients with pancreatic adenocarcinoma diagnosed between 2004 and 2020, with survival follow-up through 2022. Multivariable Cox regression analyses were performed to evaluate overall survival (OS) and cancer-specific survival (CSS) according to age group. RESULTS Among 131,839 patients, 6,366 (4.8%) had early-onset pancreatic cancer and 125,473 (95.2%) had late-onset pancreatic cancer. The median OS was 9 months for EOPC and 6 months for LOPC, while the median CSS was 10 months for EOPC and 6 months for LOPC. Adjusted OS and CSS remained worse in patients with LOPC, with consistent findings across all stages. Among patients who underwent surgery or received chemotherapy, LOPC was associated with poorer outcomes. There was no survival difference in patients with early-onset and late-onset pancreatic cancer among those who received radiation therapy. CONCLUSIONS This study demonstrated better overall survival and cancer-specific survival among EOPC after adjustment for clinical covariates including stage at diagnosis and treatment receipt, and histologic variables. The findings suggest that other factors beyond the available variables may contribute to better survival observed in younger patients. However, because information on chemotherapy regimens, treatment completion, and performance status was unavailable in the SEER database, residual confounding affecting survival outcomes cannot be excluded, and the findings should therefore be interpreted with caution.

Clinical features, treatment patterns, and outcomes of young-onset hepatocellular carcinoma: a tertiary cohort analysis with a nationwide population-based study.

Background/Aims Hepatocellular carcinoma (HCC) in younger patients is uncommon, and its clinical behavior and prognosis remain unclear. We aimed to evaluate the characteristics, treatment patterns, and outcomes of young-onset HCC using large-scale datasets. Methods This study analyzed two cohorts: the Asan Medical Center (AMC) HCC registry (2009-2023) and the nationwide Korean Liver Cancer Association (KLCA) registry. Young-onset HCC was defined as age ≤40 years. The primary comparison was between young (≤40 years) and non-young (>40 years) patients, with additional analyses using three age groups (≤40, 41-65, >65 years). Propensity score matching (PSM) was used to adjust for baseline differences. Overall survival (OS), recurrence-free survival (RFS), treatment patterns, and treatment intensity were evaluated. In the KLCA cohort, survival analyses were restricted to patients diagnosed between 2015 and 2021. Results A total of 21,699 AMC patients and 21,172 KLCA patients were included. Young-onset HCC accounted for 955 (4.4%) and 627 (3.0%) of cases, respectively. Before matching, younger patients had larger tumors, higher alpha-fetoprotein levels, and more advanced disease. After PSM, OS was comparable between groups in the AMC cohort (median 3.8 vs. 4.0 years; p=0.890) and in the KLCA cohort (median 3.7 vs. 2.9 years; p=0.053). Stage-stratified analyses showed no significant differences in OS. RFS was also similar between groups in the AMC cohort. Initial treatment distribution and longitudinal treatment intensity were comparable between groups, whereas patients aged >65 years were less likely to receive curative treatments. Conclusions Young-onset HCC shows more aggressive tumor features but similar outcomes after adjustment. Age alone may not be an independent determinant of prognosis.

Clinicopathologic Characteristics, Treatments, and Survival Outcomes of Early-onset Compared to Later-onset Colorectal Mucinous Adenocarcinomas: A Population-based SEER Analysis

Tumour deposits and oncological outcomes in early-onset colorectal cancer patients—a retrospective nationwide cohort study

The incidence of early-onset colorectal cancer (EOCRC) is rising. Tumour deposits (TDs) are an independent negative prognostic factor in colorectal cancer (CRC), but their prognostic impact in EOCRC has not been studied. This study aimed to investigate the prognostic effect of TDs on EOCRC patients. Patients who underwent surgery for CRC between 2011–2014 and 2016–2019 were extracted from the Swedish Colorectal Cancer Registry. Patients were stratified by age (EOCRC (<50 years) versus late-onset CRC (LOCRC, ≥50 years)) and TD status. Kaplan-Meier curves and multivariable Cox regression analyses were used to assess the prognostic effect of TDs in EOCRC patients on overall survival (OS) and distant metastasis (DM) adjusted for sex, number of positive lymph nodes, and neoadjuvant therapy. Of 26 970 included patients, 12.3% were TD-positive and 4.8% EOCRC. TD-positive EOCRC patients had worse 5-year OS (75.8 versus 92.4%, P < 0.001) and higher 5-year risk of DM (40.6 versus 14.7%, P < 0.001) compared to TD-negative EOCRC patients. In multivariable analysis, TDs were independently associated with increased risk of DM in both EOCRC (HR 1.55, 95% c.i. 1.16–2.07) and LOCRC (HR 1.65, 95% c.i. 1.49–1.84). However, while TD positivity in LOCRC patients was associated with worse OS (HR 1.45, 95% c.i. 1.33–1.58), no independent association with OS was observed for TD-positive EOCRC (HR 0.84, 95% c.i. 0.60–1.18). TDs are associated with an increased risk of distant metastasis in EOCRC but not with overall survival after adjustment. These findings support the prognostic relevance of TDs in EOCRC, particularly for metastatic risk.

Clinicopathological Characteristics, Molecular Findings, and Survival of Lung Cancer in Adults Aged <30 Years in China: A Retrospective Cohort Study

In this single-centre retrospective cohort, adults aged <30 years with lung cancer were predominantly female never-smokers with adenocarcinoma, and among the selectively tested advanced-stage subgroup, ALK fusions were common.

Clinicopathological differences and risk factors of early- versus late-onset pancreatic cancer: A systematic review and meta-analysis.

Pancreatic cancer is one of the most aggressive malignancies worldwide, and the incidence is increasing in patients under the age of 50. We systematically reviewed the clinicopathological features of early-onset pancreatic cancer (EOPC) and late-onset pancreatic cancer (LOPC) to help develop tailored therapeutic strategies and earlier diagnosis for younger patients. A total of 21 studies involving 1,813,719 patients were included, comprising 139,554 patients with EOPC and 1,674,165 with LOPC. EOPC was more commonly associated with tumors in the pancreatic tail, poor or undifferentiated histology, lymph node involvement, and abdominal pain at presentation, whereas LOPC more frequently involved tumors in the pancreatic head. No significant differences were observed between EOPC and LOPC in tumor resectability, surgical resection rates, or the prevalence of jaundice, cachexia, and diabetes mellitus. Overall, EOPC demonstrated a distinct clinicopathological phenotype characterized by more aggressive pathological features and advanced nodal disease, emphasizing the need for age-specific pancreatic cancer management.