E. Song1, S. Saeed3, J. Fontaine2, L. Pena3, M. Friedman3, J. Klapman3, A. Dam3, R. Mehta4, S. Hoffe5, J. Frakes5, J. Pimiento2 1University Of South Florida College Of Medicine,Tampa, FL, USA 2Moffitt Cancer Center And Research Institute,Surgical Oncology,Tampa, FL, USA 3Moffitt Cancer Center And Research Institute,GI Oncology,Tampa, FL, USA 4Moffitt Cancer Center And Research Institute,Medical Oncology,Tampa, FL, USA 5Moffitt Cancer Center And Research Institute,Radiation Oncology,Tampa, FL, USA
Introduction: Recent studies suggest survival in younger patients with esophageal cancer (EC) is worse, potentially due to differences in disease biology or more advanced stages at diagnosis. The objective of this study is to compare stage at diagnosis, patterns of treatment and outcomes of young patients ≤50 years with EC compared to older patients at a high-volume cancer center.
Methods: Query of an IRB approved database of 1039 esophagectomies at our institution revealed 97 patients ≤50 years with esophageal cancer from 1999 to 2017 who underwent an esophagectomy. Demographics, pre-treatment clinical data, treatment modality, and treatment outcomes were analyzed. Statistical analysis was performed with SPSS 24.
Results: The median age of the younger cohort is 45.8 (range, 17.6-50 yrs), with a male preponderance (78%). Median follow up is 27 months for the entire cohort. AJCC clinical staging is Stage I 9%, Stage II 37%, Stage III 44%, Stage IV 7% and unknown in 3%, which is comparable to the older cohort (p=0.20). There is a higher incidence of adenocarcinoma in those >50 compared to those ≤50 (86% vs. 76%, p=0.02). There is a higher incidence of patients ≤50 treated with neoadjuvant therapy, but did not reach statistical significance (74% vs. 66%, p=0.072). However, of those receiving neoadjuvant therapy, younger patients received more adjuvant therapy following surgery than the older group (34% vs. 10%, p=0.00). Overall, patients ≤50 had a higher chance of disease recurrence, although was not statistically significant (33% vs. 25%, p=0.12). We found no significant difference between patients younger or older than 50 when comparing type of surgery, length of stay in hospital after surgery, postoperative complications, or overall survival.
Conclusion: We found no significant difference between patients younger or older than 50 when comparing gender, clinical stage, neoadjuvant therapy administration, surgery type, length of stay in the hospital after surgery, postoperative complications, disease recurrence, or overall survival. Younger patients were more likely to receive adjuvant therapy but this did not improve outcomes, suggesting further investigation of novel systemic strategies postoperatively is needed.