Abstract 81P
Background
According to the literature, metastasectomies in colorectal cancer patients (pts) can lead to a significant increase in outcomes. However, the behavior of early-onset CRC (EO-CRC), when subjected to metastasectomy, remains unclear. Clinical and prognostic data on this setting are limited and conflicting. Our study aimed to evaluate clinical, prognostic, and molecular differences in early-onset colorectal cancer (EO-CRC) pts undergoing metastasectomy to identify potentially relevant differences compared to a control group of late-onset CRC (LO-CRC).
Methods
We retrospectively collected data from 1123 metastatic colorectal cancer pts from 5 different Italian Institutions. 673 (59.9%) EO-CRC and 450 (40.1%) LO-CRC. All pts had one or more metastatic sites, molecular profiling available, and underwent at least one line of treatment. The main objective was to evaluate clinical outcomes for the EO-CRC pts undergoing metastasectomy in comparison to pts included in the control group according to molecular profile.
Results
In the EO-CRC group, median age was 44.1 (20.0-50.9), while 64.4 (51.0-86.2) in the control group. Among EO-CRCs patients, 388 out of 673 (57.6%) underwent metastasectomy, whereas, in LO-CRCs patients, 181 out of 450 (40.2%) had the procedure. In the general population, pts who underwent metastasectomy demonstrated a higher median overall survival mOS compared to those who did not undergo the procedure. Within the metastasectomy group, EO-CRC pts exhibited a lower mOS compared to LO-CRC pts (46.0 vs 60.0 mo, p < 0.0001). Similar results were obtained when evaluating subgroups of RAS-BRAF wild type patients (53.0 vs 81.0 mo, p < 0.0001) and RAS-BRAF mutated patients (42.0 vs 45.0 mo, p < 0.0001).
Conclusions
Although EO-CRC pts seem more likely to undergo surgical resection for metastic disease, our findings suggest a worse overall prognosis for pts with EO-CRC compared to LO-CRC pts. Interestingly, this seems to occur regardless of the molecular status. These observations could have a considerable impact on clinical practice and research. Further investigations will be necessary to better understand the specific clinical and molecular characteristics of this growing group of pts to better define the most appropriate therapeutic strategy.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
A. Pretta: Financial Interests, Personal, Speaker’s Bureau: Merck. All other authors have declared no conflicts of interest.