Background:Esophageal squamous cell carcinoma (ESCC) typically occurs in older individuals. The etiology and clinical characteristics of ESCC in relatively younger patients under 60 years of age remain unclear. Understanding whether age affects tumor behavior or prognosis is important for improving patient management. This study aimed to analyze the characteristics of ESCC diagnosed before the age of 60.Methods:We retrospectively reviewed the medical records of ESCC patients diagnosed between December 2008 and May 2025. A total of 516 patients were divided into two groups based on whether they were aged 60 or above. Medical history, clinical features, and outcomes were compared between the two groups.Results:There were 100 patients under 60 years and 416 patients aged 60 and above. The median ages were 55 (range 41–59) and 72 (range 60–95), respectively. Younger patients had a significantly stronger association with heavy drinking (72.0% vs. 39.2%,p< 0.001) and smoking (76.0% vs. 55.0%,p< 0.001). There was a trend toward more advanced disease (Stage IV: 26.0% vs. 18.5%,p= 0.094) and metastatic presentation (18.0% vs. 13.9%,p= 0.305) in the under-60 group. Despite being younger with better performance status and fewer comorbidities, their overall survival did not differ from that of older patients (HR 0.92; 95% CI, 0.67–1.26;p= 0.593).Conclusions:Patients diagnosed with ESCC under the age of 60 showed a stronger association with heavy alcohol consumption and smoking and more frequent presentation with advanced-stage disease compared with older patients. Younger age did not confer a better prognosis, highlighting the importance of early detection and timely intervention regardless of patient age.
背景：食管鳞状细胞癌（ESCC）通常发生于老年人群。60岁以下相对年轻患者的ESCC病因及临床特征尚不明确。了解年龄是否影响肿瘤行为或预后对改善患者管理具有重要意义。本研究旨在分析60岁前确诊ESCC患者的临床特征。 方法：回顾性分析2008年12月至2025年5月期间确诊的ESCC患者病历资料。将516例患者按是否年满60岁分为两组，比较两组的病史、临床特征及治疗结局。 结果：60岁以下组100例，60岁及以上组416例，中位年龄分别为55岁（范围41-59岁）和72岁（范围60-95岁）。年轻患者与重度饮酒（72.0% vs. 39.2%，p<0.001）及吸烟（76.0% vs. 55.0%，p<0.001）的关联性显著更强。60岁以下组呈现疾病分期更晚（IV期：26.0% vs. 18.5%，p=0.094）和转移发生率更高（18.0% vs. 13.9%，p=0.305）的趋势。尽管年轻组体能状态更好、合并症更少，其总生存期与老年组无显著差异（HR 0.92；95% CI 0.67-1.26；p=0.593）。 结论：与老年患者相比，60岁前确诊的ESCC患者与重度饮酒及吸烟的关联性更强，且更常表现为晚期疾病。年轻并未带来更好的预后，这凸显了无论患者年龄如何，早期发现和及时干预都具有重要意义。
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