Characteristics and Prognosis of Early-Onset vs. Late-Onset Colon Cancer: A Propensity Score Matching Analysis Based on Histology

早发型与晚发型结肠癌的特征和预后:基于组织学的倾向评分匹配分析

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Abstract

OBJECTIVES: The prognostic value of age at diagnosis in colon cancer is poorly understood. This study evaluated the influence of age at diagnosis and histologic subtype on colon cancer prognosis using data from 180,804 patients in the SEER database. METHODS: Patients were stratified into early-onset and late-onset groups and by histology-adenocarcinoma or mucinous adenocarcinoma. Early-onset colon cancer was associated with more advanced tumor stages. Propensity score matching balanced cohorts for Kaplan-Meier and Cox regression analyses of cancer-specific survival (CSS) and surgery-specific survival (SSS). RESULTS: Survival analyses revealed that patients with early-onset adenocarcinoma had the most favorable CSS and SSS, whereas those with late-onset mucinous adenocarcinoma experienced the worst outcomes; no significant age-related differences emerged histology-stratified. Importantly, among nonmetastatic patients, early-onset adenocarcinoma showed significantly poorer SSS compared to late-onset adenocarcinoma. CONCLUSION: These findings emphasize the necessity of integrating age and histologic type for accurate prognostic assessment and personalized treatment strategies in colon cancer.

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