To compare the lymph-node metastasis (LNM) rates between early-onset (EO) and late-onset (LO) T1 colorectal cancer (CRC) through an integrated analysis of previously published reports.
Approach:
Meta-Analysis Methodology: The study followed MOOSE guidelines and registered the protocol with PROSPERO. It included studies analyzing LNM prevalence in T1 CRC, focusing on age-specific rates.
Eligibility Criteria: Included studies had to report age-specific LNM rates for T1 CRC, with EO defined as cases diagnosed at < 50 years. Studies without age-specific data or with insufficient statistical power were excluded.
Data Sources: The search included databases like PubMed/MEDLINE, SCOPUS, Cochrane Library, and others, with a focus on relevant MeSH terms and keywords related to CRC and LNM.
Statistical Analysis: Meta-analysis was performed using inverse variance methods, assessing heterogeneity with Cochran’s Q test and I2 statistic. Publication bias was evaluated using funnel plots.
Sensitivity Analysis: Conducted to address potential bias from overlapping datasets, including various configurations of SEER data.
Key Findings:
LNM occurs in approximately 10% of patients with T1 CRC.
The study identified a gap in research regarding the association between younger age and LNM in T1 CRC.
Interpretation:
No consensus exists on whether EO-T1 CRC should be managed similarly to LO-T1 CRC due to differing LNM rates.
Limitations:
Limited studies specifically investigating EO-T1 CRC and LNM may impact the conclusions drawn.
Potential bias from overlapping datasets in included studies.
Conclusion:
The findings highlight the need for further research on LNM risk in EO-T1 CRC to inform management strategies.
