{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T03:10:29Z","timestamp":1780110629466,"version":"3.54.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The National Health & Medical Research Council of Australia"},{"DOI":"10.13039\/501100001102","name":"Cancer Council NSW","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001171","name":"Cancer Institute NSW","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001171","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011371","name":"Royal Australasian College of Surgeons","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011371","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012187","name":"St Vincent\u2019s Clinic Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012187","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019436","name":"The Australian Pancreatic Cancer Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019436","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The increase in incidence of early-onset pancreatic cancer (EOPC) is of concern and poorly understood. The aim of this study was to investigate the clinical outcomes of surgically resected patients with EOPC and the potential molecular heterogeneity between EOPC and late age-onset disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted, with clinical, pathological, and survival outcome data obtained from two large independent prospective cohorts curated by the Australian Pancreatic Genome Initiative (APGI) and the West of Scotland Pancreatic Unit (Glasgow Royal Infirmary) between 1997 and 2022. Patients were categorized into two age groups (&amp;lt;50 and \u226550\u2005years) at time of diagnosis. Clinicopathological features and survival outcomes, in addition to gene expression and tumour microenvironment data, were compared between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 851 patients were identified, of whom 68 (8%) were aged &amp;lt;50\u2005years. EOPC was associated with significantly earlier recurrence after surgery (median disease-free survival (DFS) 10.9 versus 14.2\u2005months; P = 0.011) and there was no statistically significant difference in disease-specific survival (median 19.9 versus 23.8\u2005months; P = 0.117). There were no differences in validated clinicopathological variables to account for the shorter DFS in the EOPC group. Despite an increased proportion of patients with EOPC receiving adjuvant chemotherapy (P = 0.032), DFS was significantly worse (DFS 12.6 versus 16.0\u2005months; P = 0.022). EOPC demonstrated enrichment of genes associated with more aggressive molecular pathology and the squamous (basal-like) molecular subtype of pancreatic ductal adenocarcinoma, including S100A2 (P &amp;lt; 0.001) and TP63 (P = 0.044), and down-regulation of GATA6 (P = 0.016).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EOPC is associated with a shorter time to recurrence and more aggressive, adverse molecular pathology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znag032","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:42:24Z","timestamp":1773924144000},"source":"Crossref","is-referenced-by-count":1,"title":["Clinical and molecular landscape of surgically resected early onset pancreatic cancer"],"prefix":"10.1093","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6134-2096","authenticated-orcid":false,"given":"Stephan B","family":"Dreyer","sequence":"first","affiliation":[{"name":"Wolfson Wohl Cancer Research Centre, School of Cancer Sciences, University of Glasgow , Glasgow ,","place":["UK"]},{"name":"West of Scotland Pancreatic Unit, Glasgow Royal Infirmary , Glasgow ,","place":["UK"]},{"name":"Department of HPB\/Transplant Surgery, Royal Infirmary of Edinburgh , Edinburgh ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Bryce","sequence":"additional","affiliation":[{"name":"Wolfson Wohl Cancer Research Centre, School of Cancer Sciences, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fieke","family":"Froeling","sequence":"additional","affiliation":[{"name":"Wolfson Wohl Cancer Research Centre, School of Cancer Sciences, University of Glasgow , Glasgow ,","place":["UK"]},{"name":"Department of Oncology, Beatson West of Scotland Cancer Centre , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Jackson","sequence":"additional","affiliation":[{"name":"West of Scotland Pancreatic Unit, Glasgow Royal Infirmary , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonor","family":"Santana","sequence":"additional","affiliation":[{"name":"Wolfson Wohl Cancer Research Centre, School of Cancer Sciences, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Euan J","family":"Dickson","sequence":"additional","affiliation":[{"name":"West of Scotland Pancreatic Unit, Glasgow Royal Infirmary , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Coats","sequence":"additional","affiliation":[{"name":"West of Scotland Pancreatic Unit, Glasgow Royal Infirmary , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"McKay","sequence":"additional","affiliation":[{"name":"West of Scotland Pancreatic Unit, Glasgow Royal Infirmary , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Holroyd","sequence":"additional","affiliation":[{"name":"West of Scotland Pancreatic Unit, Glasgow Royal Infirmary , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew V","family":"Biankin","sequence":"additional","affiliation":[{"name":"Wolfson Wohl Cancer Research Centre, School of Cancer Sciences, University of Glasgow , Glasgow ,","place":["UK"]},{"name":"West of Scotland Pancreatic Unit, Glasgow Royal Infirmary , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9552-4725","authenticated-orcid":false,"given":"Nigel B","family":"Jamieson","sequence":"additional","affiliation":[{"name":"Wolfson Wohl Cancer Research Centre, School of Cancer Sciences, University of Glasgow , Glasgow ,","place":["UK"]},{"name":"West of Scotland Pancreatic Unit, Glasgow Royal Infirmary , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K","family":"Chang","sequence":"additional","affiliation":[{"name":"Wolfson Wohl Cancer Research Centre, School of Cancer Sciences, University of Glasgow , Glasgow ,","place":["UK"]},{"name":"West of Scotland Pancreatic Unit, Glasgow Royal Infirmary , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"2026050709295714800_znag032-B1","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1016\/S0140-6736(17)33326-3","article-title":"Global surveillance of trends in cancer survival 2000\u201314 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries","volume":"391","author":"Allemani","year":"2018","journal-title":"Lancet"},{"key":"2026050709295714800_znag032-B2","volume-title":"Cancer Survival in England, cancers diagnosed 2015 to 2019, followed up to 2020","author":"NHS England Digital"},{"key":"2026050709295714800_znag032-B3","first-page":"12","article-title":"Cancer statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"2026050709295714800_znag032-B4","doi-asserted-by":"crossref","first-page":"e213","DOI":"10.1097\/MPA.0000000000002231","article-title":"Rising incidence of pancreatic cancer in patients 20 to 39\u2005years: a population-based observational study","volume":"52","author":"Ramai","year":"2023","journal-title":"Pancreas"},{"key":"2026050709295714800_znag032-B5","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/S2468-1253(23)00039-0","article-title":"Cause for concern: the rising incidence of early-onset pancreatic cancer","volume":"8","author":"The Lancet Gastroenterology Hepatology","year":"2023","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2026050709295714800_znag032-B6","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1158\/2159-8290.CD-22-1038","article-title":"Early-onset cancer in the gastrointestinal tract is on the rise\u2014evidence and implications","volume":"13","author":"Ben-Aharon","year":"2023","journal-title":"Cancer Discov"},{"key":"2026050709295714800_znag032-B7","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1053\/j.gastro.2023.01.022","article-title":"Increasing pancreatic cancer incidence in young women in the United States: a population-based time-trend analysis, 2001\u20132018","volume":"164","author":"Abboud","year":"2023","journal-title":"Gastroenterology"},{"key":"2026050709295714800_znag032-B8","doi-asserted-by":"crossref","first-page":"e398068","DOI":"10.1200\/EDBK_398068","article-title":"Early-onset GI cancers: rising trends, genetic risks, novel strategies, and special considerations","volume":"43","author":"Harrold","year":"2023","journal-title":"Am Soc Clin Oncol Educ Book"},{"key":"2026050709295714800_znag032-B9","doi-asserted-by":"crossref","first-page":"e137","DOI":"10.1016\/S2468-2667(18)30267-6","article-title":"Emerging cancer trends among young adults in the USA: analysis of a population-based cancer registry","volume":"4","author":"Sung","year":"2019","journal-title":"Lancet Public Health"},{"key":"2026050709295714800_znag032-B10","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.pan.2023.12.005","article-title":"The burden of young-onset pancreatic cancer and its risk factors from 1990 to 2019: a systematic analysis of the global burden of disease study 2019","volume":"24","author":"Dahia","year":"2024","journal-title":"Pancreatology"},{"key":"2026050709295714800_znag032-B11","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1038\/s41571-020-00445-1","article-title":"Rising incidence of early-onset colorectal cancer\u2014a call to action","volume":"18","author":"Akimoto","year":"2021","journal-title":"Nat Rev Clin Oncol"},{"key":"2026050709295714800_znag032-B12","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1007\/s12664-013-0396-0","article-title":"Rectal cancer in young Indians\u2014are these cancers different compared to their older counterparts?","volume":"33","author":"Barreto","year":"2014","journal-title":"Indian J Gastroenterol"},{"key":"2026050709295714800_znag032-B13","doi-asserted-by":"crossref","first-page":"4009","DOI":"10.1200\/JCO.21.02008","article-title":"Early-onset colorectal adenocarcinoma in the IDEA database: treatment adherence, toxicities, and outcomes with 3 and 6 months of adjuvant fluoropyrimidine and oxaliplatin","volume":"39","author":"Fontana","year":"2021","journal-title":"J Clin Oncol"},{"key":"2026050709295714800_znag032-B14","doi-asserted-by":"crossref","first-page":"e2300152","DOI":"10.1200\/PO.23.00152","article-title":"Multiomic characterization reveals a distinct molecular landscape in young-onset pancreatic cancer","volume":"7","author":"Ogobuiro","year":"2023","journal-title":"JCO Precis Oncol"},{"key":"2026050709295714800_znag032-B15","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.pan.2015.01.013","article-title":"Early onset pancreatic cancer: risk factors, presentation and outcome","volume":"15","author":"Piciucchi","year":"2015","journal-title":"Pancreatology"},{"key":"2026050709295714800_znag032-B16","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1038\/s41416-024-02619-5","article-title":"Early onset pancreatic cancer\u2014exploring contemporary treatment and outcomes using real-world data","volume":"130","author":"Mendis","year":"2024","journal-title":"Br J Cancer"},{"key":"2026050709295714800_znag032-B17","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1038\/nature09515","article-title":"Distant metastasis occurs late during the genetic evolution of pancreatic cancer","volume":"467","author":"Yachida","year":"2010","journal-title":"Nature"},{"key":"2026050709295714800_znag032-B18","doi-asserted-by":"crossref","first-page":"e396","DOI":"10.1097\/SLA.0000000000005050","article-title":"The impact of molecular subtyping on pathological staging of pancreatic cancer","volume":"277","author":"Dreyer","year":"2023","journal-title":"Ann Surg"},{"key":"2026050709295714800_znag032-B19","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/SLA.0000000000003143","article-title":"Precision oncology in surgery: patient selection for operable pancreatic cancer","volume":"272","author":"Dreyer","year":"2020","journal-title":"Ann Surg"},{"key":"2026050709295714800_znag032-B20","doi-asserted-by":"crossref","first-page":"e183","DOI":"10.1002\/bjs.10772","article-title":"Defining the molecular pathology of pancreatic body and tail adenocarcinoma","volume":"105","author":"Dreyer","year":"2018","journal-title":"Br J Surg"},{"key":"2026050709295714800_znag032-B21","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1038\/nature16965","article-title":"Genomic analyses identify molecular subtypes of pancreatic cancer","volume":"531","author":"Bailey","year":"2016","journal-title":"Nature"},{"key":"2026050709295714800_znag032-B22","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1002\/jso.21292","article-title":"Pancreatic adenocarcinoma in a young patient population\u201412-year experience at Memorial Sloan Kettering Cancer Center","volume":"100","author":"Duffy","year":"2009","journal-title":"J Surg Oncol"},{"key":"2026050709295714800_znag032-B23","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1053\/j.gastro.2021.09.022","article-title":"Genomic and molecular analyses identify molecular subtypes of pancreatic cancer recurrence","volume":"162","author":"Dreyer","year":"2022","journal-title":"Gastroenterology"},{"key":"2026050709295714800_znag032-B24","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1038\/ng.3398","article-title":"Virtual microdissection identifies distinct tumor- and stroma-specific subtypes of pancreatic ductal adenocarcinoma","volume":"47","author":"Moffitt","year":"2015","journal-title":"Nat Genet"},{"key":"2026050709295714800_znag032-B25","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1038\/nm.2344","article-title":"Subtypes of pancreatic ductal adenocarcinoma and their differing responses to therapy","volume":"17","author":"Collisson","year":"2011","journal-title":"Nat Med"},{"key":"2026050709295714800_znag032-B26","doi-asserted-by":"crossref","first-page":"2185","DOI":"10.1158\/1078-0432.CCR-18-3042","article-title":"Genomic landscape of pancreatic adenocarcinoma in younger versus older patients: does age matter?","volume":"25","author":"Ben-Aharon","year":"2019","journal-title":"Clin Cancer Res"},{"key":"2026050709295714800_znag032-B27","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1158\/1078-0432.CCR-20-1042","article-title":"Delving into early-onset pancreatic ductal adenocarcinoma: how does age fit in?","volume":"27","author":"Tsang","year":"2021","journal-title":"Clin Cancer Res"},{"key":"2026050709295714800_znag032-B28","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.3390\/cancers13061234","article-title":"Pancreatic ductal adenocarcinoma arising in young and old patients displays similar molecular features","volume":"13","author":"Raffenne","year":"2021","journal-title":"Cancers (Basel)"},{"key":"2026050709295714800_znag032-B29","doi-asserted-by":"crossref","first-page":"1894","DOI":"10.1158\/1055-9965.EPI-07-0341","article-title":"Early onset pancreatic cancer: evidence of a major role for smoking and genetic factors","volume":"16","author":"Raimondi","year":"2007","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2026050709295714800_znag032-B30","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s40487-025-00405-8","article-title":"Definition of sporadic early-onset invasive solid organ cancers in adults","volume":"14","author":"Barreto","year":"2026","journal-title":"Oncol Ther"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/113\/5\/znag032\/68238931\/znag032.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/113\/5\/znag032\/68238931\/znag032.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T13:30:06Z","timestamp":1778160606000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/doi\/10.1093\/bjs\/znag032\/8671873"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":30,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,7]]},"published-print":{"date-parts":[[2026,5,7]]}},"URL":"https:\/\/doi.org\/10.1093\/bjs\/znag032","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2026,5]]},"article-number":"znag032"}}