Comparison of clinicopathological features and prognostic analysis between early-onset and late-onset advanced rectal mucinous adenocarcinoma

Abstract

[Objectives] To compare the clinicopathological features with early-onset and late-onset advanced rectal mucinous adenocarcinoma and analysis the prognosis. [Methods] This study collected patients with first diagnosed advanced rectal mucinous adenocarcinoma from 2010 to 2020 through the SEER database. According to the age at diagnosis, patients were divided into an early-onset group (age0.05). Compared with the late-onset group, the early-onset group had lower patients proportions of divorce, separation, or widowhood (11.6% vs. 27.4%), 1-11 lymph node dissections (19.4% vs. 27.4%), and cancer nodule negativity (67.7% vs. 76.1%). However, the early-onset group had higher patients proportions of TNM stage Ⅲ (76.1% vs. 58.6%), N2 stage (33.5% vs. 18.1%), >20 lymph node dissections (29.7% vs. 19.9%), lymph node positivity (58.1% vs. 45.4%), receiving chemotherapy (93.5% vs. 78.8%), receiving radiotherapy (75.5% vs. 56.1%), and receiving full course systemic therapy (41.3% vs. 21.2%) (P5 cm, no chemotherapy, preoperative + postoperative radiotherapy, and preoperative systemic therapy were independent risk factors for survival prognosis in advanced rectal mucinous adenocarcinoma. Cox proportional hazards regression model analysis was also performed on 155 cases of early-onset advanced rectal mucinous adenocarcinoma, showing that unmarried or unknown marital status and positive perineural invasion were independent risk factors for survival prognosis in early-onset advanced rectal mucinous adenocarcinoma. [Conclusion] The possibility of adverse prognostic factors is higher in early-onset advanced rectal mucinous adenocarcinoma, such as a higher proportion of stage Ⅲ and lymph node positivity, and a lower proportion of cancer nodule negativity. However, its long-term or short-term survival outcomes are superior to those of late-onset advanced rectal mucinous adenocarcinoma, which may be related to adequate lymph node dissection during surgery and chemotherapy receipt.

Keywords

• rectal mucinous adenocarcinoma
• early-onset
• late-onset
• seer database
• survival analysis