Abstract:
Objective
To compare the clinical characteristics， pathologic features and survival outcomes of early-onset and late-onset locally advanced rectal cancer.
Methods
Clinical data of locally advanced rectal cancer patients admitted in our hospital from January 2019 to January 2022 were retrospectively analyzed. According to the age of onset， the patients were divided into early-onset（＜50 years） and late-onset （≥50 years） groups. The primary outcomes were 3-year disease-free survival（3y-DFS） and overall survival （3y-OS）.
Results
A total of 464 locally advanced rectal cancer patients were included， including 92 （19.8%） in early-onset group and 372 （80.2%） in late-onset group. Early-onset patients was more common in women （40.2% vs. 29.3%， P=0.043）， and the proportion of ASA grade I was higher（83.7% vs. 50.0%， P＜0.001）. The pathological complete response rate （33.7% vs. 23.4%， P=0.042） and the proportion of CAP 0-1 grade （62.0% vs. 50.3%， P=0.044） in early-onset group were significantly higher than that in late-onset group. The median follow-up time was 39 （25～52） months with the follow-up rate of 99.8%.Approximately 60 patients had distant metastasis （13 patients in early-onset and 47 patients in late-onset） and 8 patients had tumor relapse （5 patients in early-onset and 3 patients in late-onset）. The distant metastasis rate and local recurrence rate were 12.9% and 1.7%， respectively， and there was no significant difference between the two groups （all P＞0.05）. There was no significant difference in 3y-DFS （81.9% vs. 86.3%， P=0.531） and 3y-OS （92.6% vs. 94.2%， P=0.708） between patients with early-onset rectal cancer and those with late-onset rectal cancer.
Conclusion
Compared to late-onset group， patients in the early-onset group is more common in females， and exhibit a relatively superior response to neoadjuvant chemoradiotherapy， but this kind of better local control of disease did not result in an improved long-term survival outcomes.
Key words:
Rectal neoplasms,
Early-onset,
Late-onset,
Pathological features,
Prognosis
Ganbin Li, Xiao Zhang, Xiaoyuan Qiu, Chentong Wang, Lai Xu, Beizhan Niu, Guannan Zhang, Junyang Lu, Bin Wu, Yi Xiao, Guole Lin. Clinicopathological features and prognosis of early- and late-onset locally advanced rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2025, 14(03): 234-241.