ArticleScientific reports2026
Age-dependent prognostic value of biological age for metastasis and survival in gastrointestinal cancer.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Chronological age is a recognized cancer risk factor but does not capture inter-individual differences in systemic aging. Biological age, reflecting cumulative functional decline, may better predict cancer outcomes. This study examined associations between biological age, disease characteristics, metastasis, and survival in gastrointestinal cancers.
methodsWe retrospectively analyzed 3,074 patients. Biological age was estimated from clinical biomarkers, and ΔAge (biological-chronological age) was calculated. Patients were grouped by biological age quartiles. Logistic and Cox regression, Kaplan-Meier, restricted cubic splines, and subgroup/sensitivity analyses were conducted. A prognostic nomogram integrating biological age was developed and validated.
resultsHigher biological age correlated with older chronological age, male sex, smoking, systemic inflammation, and lower nutrition. ΔAge was largest in patients < 50 years. Biological age was not associated with TNM stage but independently predicted metastasis (per 1-SD: OR = 1.02, 95% CI: 1.01-1.03). The highest quartile nearly doubled metastasis risk, most evident in patients aged 50-64 years. During a median 47.9-month follow-up, 951 deaths occurred. Elevated biological age predicted poorer survival (highest vs. second quartile: HR = 2.04, 95% CI: 1.58-2.62), with nonlinear dose-response associations. Prognostic value was stronger in middle-aged and older patients. The nomogram demonstrated good discrimination (C-index 0.687-0.732; AUCs up to 0.846).
conclusionsBiological age, independent of chronological age and TNM stage, is a strong predictor of metastasis and survival in gastrointestinal cancers. ΔAge is greatest in younger individuals, while prognostic impact is most pronounced in middle-aged and older patients. Incorporating biological age may improve risk stratification and individualized management.
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