Clinicopathological differences and risk factors of early- versus late-onset pancreatic cancer: A systematic review and meta-analysis.

Pancreatic cancer is one of the most aggressive malignancies worldwide, and the incidence is increasing in patients under the age of 50. We systematically reviewed the clinicopathological features of early-onset pancreatic cancer (EOPC) and late-onset pancreatic cancer (LOPC) to help develop tailored therapeutic strategies and earlier diagnosis for younger patients. A total of 21 studies involving 1,813,719 patients were included, comprising 139,554 patients with EOPC and 1,674,165 with LOPC. EOPC was more commonly associated with tumors in the pancreatic tail, poor or undifferentiated histology, lymph node involvement, and abdominal pain at presentation, whereas LOPC more frequently involved tumors in the pancreatic head. No significant differences were observed between EOPC and LOPC in tumor resectability, surgical resection rates, or the prevalence of jaundice, cachexia, and diabetes mellitus. Overall, EOPC demonstrated a distinct clinicopathological phenotype characterized by more aggressive pathological features and advanced nodal disease, emphasizing the need for age-specific pancreatic cancer management.