Journal of Clinical Medicine
Molecular Profiles, Treatment-Associated Survival, and Prognosis in Early-Onset Versus Late-Onset Gastric Cancer: A Systematic Review and Meta-Analysis
By Jianbin Wen and Lin-Yong Zhao.
Abstract
Background
Whether early-onset gastric cancer (EOGC) represents a distinct clinical entity requiring age-specific management remains uncertain. We synthesized molecular profiles, treatment-associated survival, and prognosis to determine what current evidence supports in practice and requires prospective validation.
Methods
This PROSPERO-registered, PRISMA-compliant review searched four databases (PubMed, Web of Science Core Collection, Embase, and the Cochrane Library) from 1990 to 2025. Random-effects models compared EOGC with late-onset gastric cancer (LOGC) using each study’s reported age definition, provided that the upper age cutoff for EOGC did not exceed 50 years, and evaluated treatment–survival associations within EOGC. Robustness was evaluated by restricted maximum likelihood (REML) estimation with Knapp–Hartung adjustment, subgroup analyses, meta-regression, and prediction intervals; certainty was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).