Clinical and molecular characteristics of early-onset vs average-onset esophagogastric cancer

The rate of esophagogastric cancer is rising among individuals under 50 years of age. It remains unknown whether early-onset esophagogastric cancer represents a unique entity. This study investigated the clinical and molecular characteristics of early-onset and average-onset esophagogastric cancer ....

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Published in:JNCI : Journal of the National Cancer Institute Vol. 116; no. 2; p. 299
Main Authors: Lumish, Melissa A, Walch, Henry, Maron, Steven B, Chatila, Walid, Kemel, Yelena, Maio, Anna, Ku, Geoffrey Y, Ilson, David H, Won, Elizabeth, Li, Jia, Joshi, Smita S, Gu, Ping, Schattner, Mark A, Laszkowska, Monika, Gerdes, Hans, Jones, David R, Sihag, Smita, Coit, Daniel G, Tang, Laura H, Strong, Vivian E, Molena, Daniela, Stadler, Zsofia K, Schultz, Nikolaus, Janjigian, Yelena Y, Cercek, Andrea
Format: Journal Article
Language:English
Published: United States 08.02.2024
Subjects:
Adenocarcinoma - epidemiology
Adenocarcinoma - genetics
Adolescent
Adult
Aged
Aged, 80 and over
Carcinoma, Signet Ring Cell - metabolism
Carcinoma, Signet Ring Cell - pathology
Cardia - metabolism
Esophageal Neoplasms - epidemiology
Esophageal Neoplasms - genetics
Esophagogastric Junction - metabolism
Esophagogastric Junction - pathology
Female
Humans
Middle Aged
Retrospective Studies
Stomach Neoplasms - diagnosis
Stomach Neoplasms - epidemiology
Stomach Neoplasms - genetics
Young Adult
ISSN:1460-2105, 1460-2105
Online Access:Get more information
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Summary:The rate of esophagogastric cancer is rising among individuals under 50 years of age. It remains unknown whether early-onset esophagogastric cancer represents a unique entity. This study investigated the clinical and molecular characteristics of early-onset and average-onset esophagogastric cancer . We reviewed the Memorial Sloan Kettering Cancer Center gastric, esophageal, and gastroesophageal junction cancer database. Associations between baseline characteristics and tumor and germline molecular alterations were compared between those with early-onset and average-onset esophagogastric cancer using Fisher exact tests and the Benjamini-Hochberg method for multiple-hypothesis correction. We included 1123 patients with early-onset esophagogastric cancer (n = 219; median age = 43 years [range = 18-49 years]) and average-onset esophagogastric cancer (n = 904; median age = 67 years [range = 50-94 years]) treated between 2005 and 2018. The early-onset group had more women (39% vs 28%, P = .002). Patients with early-onset esophagogastric cancer were more likely to have a gastric primary site (64% vs 44%, P < .0001). The signet ring cell and/or diffuse type was 3 times more common in the early-onset esophagogastric cancer group (31% vs 9%, P < .0001). Early-onsite tumors were more frequently genomically stable (31% vs 18%, P = .0002) and unlikely to be microsatellite instability high (2% vs 7%, P = .003). After restricting to adenocarcinoma and signet ring cell and/or diffuse type carcinomas, we observed no difference in stage (P = .40) or overall survival from stage IV diagnosis (median = 22.7 vs 22.1 months, P = .78). Our study supported a preponderance of gastric primary disease sites, signet ring histology, and genomically stable molecular subtypes in early-onset esophagogastric cancer. Our findings highlight the need for further research to define the underlying pathogenesis and strategies for early detection and prevention.
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ISSN:1460-2105
1460-2105
DOI:10.1093/jnci/djad186