早发型结直肠癌的发病率正在上升。目前尚不清楚转移性结直肠癌年轻和老年患者之间是否存在生存差异。

我们研究了2326例入选癌症和白血病B组和SWOG 80405试验(一线化疗加生物制剂的多中心随机试验)的mCRC患者的年龄与生存期的关系。本研究的主要和次要结局分别为总生存期(OS)和无进展生存期(PFS)，采用Kaplan-Meier法评估，并采用log-rank检验对年轻患者和老年患者进行比较。根据Cox比例风险模型计算风险比(HRs)和95%置信区间(ci)，并对已知的预后变量进行调整。所有统计检验均为双面检验。

2326名合格受试者中，514人(22.1%)在研究开始时年龄小于50岁(早发性结肠癌队列)。早发性结肠癌患者的中位年龄为44.3岁，50岁及以上患者的中位年龄为62.5岁。早发性结肠癌与老年起病患者的OS无统计学差异(中位= 27.07 vs 26.12个月;调整HR = 0.98, 95% CI = 0.88 ~ 1.10)。早发性结肠癌与老年患者的中位PFS也相似(10.87 vs 10.55个月)，调整后的风险比为1.02 (95% CI = 0.92 ~ 1.13)。年龄小于35岁的患者OS最短，中位OS为21.95，年龄较大的患者OS为26.12个月，调整后的风险比为1.08 (95% CI = 0.81 ~ 1.44)

Abstract

Background: The incidence of young-onset colorectal cancer (yoCRC) is increasing. It is unknown if there are survival differences between young and older patients with metastatic colorectal cancer (mCRC).

Methods: We studied the association of age with survival in 2326 mCRC patients enrolled in the Cancer and Leukemia Group B and SWOG 80405 trial, a multicenter, randomized trial of first-line chemotherapy plus biologics. The primary and secondary outcomes of this study were overall survival (OS) and progression-free survival (PFS), respectively, which were assessed by Kaplan-Meier method and compared among younger vs older patients with the log-rank test. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated based on Cox proportional hazards modeling, adjusting for known prognostic variables. All statistical tests were 2-sided.

Results: Of 2326 eligible subjects, 514 (22.1%) were younger than age 50 years at study entry (yoCRC cohort). The median age of yoCRC patients was 44.3 vs 62.5 years in patients aged 50 years and older. There was no statistically significant difference in OS between yoCRC vs older-onset patients (median = 27.07 vs 26.12 months; adjusted HR = 0.98, 95% CI = 0.88 to 1.10; P = .78). The median PFS was also similar in yoCRC vs older patients (10.87 vs 10.55 months) with an adjusted hazard ratio of 1.02 (95% CI = 0.92 to 1.13; P = .67). Patients younger than age 35 years had the shortest OS with median OS of 21.95 vs 26.12 months in older-onset patients with an adjusted hazard ratio of 1.08 (95% CI = 0.81 to 1.44; Ptrend = .93).

Conclusion: In this large study of mCRC patients, there were no statistically significant differences in survival between patients with yoCRC and CRC patients aged 50 years and older.

原文链接

pubmed.ncbi.nlm.nih.gov/34636852/

百度浏览   来源 : 医微客   

版权声明：本网站所有注明来源“医微客”的文字、图片和音视频资料，版权均属于医微客所有，非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源：”医微客”。本网所有转载文章系出于传递更多信息之目的，且明确注明来源和作者，转载仅作观点分享，版权归原作者所有。不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。 本站拥有对此声明的最终解释权。