Real-world data of early-onset colorectal cancer (EOCRC) in private health system in Brazil

e18830 Background: Incidence of EOCRC has been sharply rising in the past decades in the US and present distinct clinical features when compared to late-onset CRC (LOCRC). Data from other countries are scarce. We compared clinical characteristics and treatment outcomes between patients ≤45y (EOCRC) and ≥60y (LOCRC). Methods: Retrospective study evaluating 510 patients with metastatic CRC treated at 5 Oncoclinicas centers in Brazil from January 2011 to December 2019. Demographic and clinical data were retrieved from electronic medical records. The median OS was calculated by Kaplan-Meier method and prognostic factors were evaluated via multivariate Cox Regression. Results: After excluding patients with ages between 46 and 59, 326 patients were identified. EOCRC was represented by 72 (22%) patients (median age 39) and LOCRC by 254 patients (median age 69). Median follow-up was 39.5m, with 231 deaths (71%). Median OS was 33.2m and 40.9m (p = 0.971), respectively. Likewise, stage IV at presentation was similar between the groups (68% vs 58%, p = 0.215), as well as the rate of dMMR status (4% vs 6%, p = 0.655). Clinical and treatment characteristics that were statistically different between the groups are described in Table 1. In multivariate analysis, presence of RAS mutations (HR:1.83), and undergoing triplet chemotherapy (HR:3.24), primary tumor resection (HR:0.40), and metastasectomy (HR:0.45) were the variables with prognostic effect on OS. Conclusions: In this real-world analysis of mCRC, EOCRC patients presented similar clinical presentation and OS, but they were more aggressively treated compared to the older patients. There is no evidence that more intensive treatments translate into superior clinical outcomes in young patients. Real-world data have been progressively adopted in clinical practice and should be considered before clinical decision making in order to offer treatments with minimal toxicity burden to the patients. Future studies with larger population are needed and may bring additional data. [Table: see text]