Comparison of postoperative survival prognosis between early-onset and late-onset esophageal cancer: A Population-based study

The prognosis of non-distant metastatic early-onset esophageal cancer (EC) patients undergoing surgical treatment remains unclear, this study aims to compare the prognosis of early-onset and late-onset EC. Information on non-distant metastatic EC patients who underwent surgical treatment and were initially diagnosed between 2004 and 2015 was collected from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was used to balance the baseline differences between early-onset and late-onset EC patients. Univariate and multivariate Cox regression analyses were used to calculate hazard ratio (HR) and 95% confidence interval (CI). The Kaplan-Meier method and log-rank test were used to compare the overall survival (OS) between the two groups of patients. Atotal of 5320 EC patients were included, with 571 in the early-onset group and 4749 in the late-onset group. Multivariate Cox regression analysis showed that early-onset EC patients had better OS (HR = 0.732, 95% CI: 0.655-0.819, p<0.001). Using PSM analysis at a 1:1 ratio, we matched 557 early-onset EC patients with 557 late-onset EC patients. After matching, the multivariate Cox regression model still showed a favorable prognosis for early-onset EC (HR = 0.728, 95% CI: 0.630-0.842, p<0.001). Additionally, subgroup analysis indicated that early-onset EC patients had better long-term prognosis. Non-distant metastatic early-onset EC patients undergoing surgical treatment demonstrated better OS outcomes, confirmed by regression analysis and subgroup analysis in the matched cohort.