title: Clinicopathological features and prognosis of patients <45 years old with esophageal adenocarcinoma comparing to other age groups.
abstract: BACKGROUND
  To analyze the clinicopathological features and prognosis of younger patients with esophageal adenocarcinoma (EAC).
  
  
  METHODS
  A total of 2,601 patients diagnosed with EAC between 1988 and 2011 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. All patients underwent primary tumor resection and regional lymphadenectomy without preoperative radiotherapy. The patients were into four age groups (<45, 45-59, 60-74, ≥75), with 94, 813, 1,272 and 422 patients in each group respectively.
  
  
  RESULTS
  Patients in the age <45 group were more likely to have lymph node (LN) metastasis (P=0.002), postoperative radiotherapy (P<0.001) and advanced T and N stage (P=0.003, 0.014) compared to the other three groups. We then conducted two Cox proportional hazards model adjusted for the sex, race, number of LNs examined, histological grade, postoperative radiation. The hazard ratio (HR) was higher in patients <45 y and the survival rate were paradoxically lower compared to the patients between 45-60 years old (P=0.046, 0.039).
  
  
  CONCLUSIONS
  The patients <45 y had the most aggressive clinicopathological features of EAC and poorer survival rate after radical esophagectomy.
authors.affiliation: Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Su
authors.initials: S
authors.lastname: Yang
authors.affiliation: School of Public Health, Wannan Medical College, Wuhu 241002, China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Li
authors.affiliation: The 2nd Department of Thoracic Surgery, Jilin Province Cancer Hospital, Changchun 130012, China.
authors.forename: Chunyi
authors.initials: C
authors.lastname: Jia
authors.affiliation: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.affiliation: Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Hecheng
authors.initials: H
authors.lastname: Li
keywords: Esophageal adenocarcinoma (EAC); prognosis; the Surveillance, Epidemiology, and End Results (SEER); young patients