Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and long-term: Analysis of survival and prognostic markers (original) (raw)
Related papers
Erciyes Medical Journal, 2019
Objective: Although its incidence has been increasing, colorectal cancer is rare in young patients. There are conflicting reports on its prognosis in young patients with colorectal cancers. The goal of this study is to investigate the prognostic factors in young patients with colorectal cancer. An observational, population-based, retrospective study. Materials and Methods: The clinicopathological characteristics, treatment approaches, and survival data of patients with colorectal cancers aged 30 years and younger were retrospectively analyzed. Results: A total of 32 patients were identified. Hematochezia and abdominal pain were the major signs of colorectal cancer. Left-sided tumors (rectum 53.1%, and left colon 25%) were found to be more common than right-sided (18.8%) and transverse colon tumors (3.1%). Curative surgery was performed in 81.3% of patients. Histologically, 43.8% of cancers found were poorly differentiated. According to the subtype, 21.9% were signet ring cell, and 25% were mucinous (colloid) tumors. Patients were evaluated as Stage III in 46.9% and Stage IV in 31.3% of cases. The 3-year progression-free survival (PFS) was 38.7%, and the 3-year overall survival (OS) was 53.2%. Stage IV disease and disease without curative surgery were poor prognostic factors, both for the OS and PFS. Conclusion: Prognosis was poor in young patients with colorectal cancer. In this institutional study, an advanced stage, left-sided localization, and poor histological feature were frequently detected. The stage and complete surgery were predictive factors for the long-term survival. In this respect, it is important for physicians to heighten their awareness of the increased incidence of colon cancer in younger patients.
Young age is not a poor prognostic marker in colorectal cancer
British Journal of Surgery, 1998
BackgroundThere is still considerable controversy and debate regarding the features and prognosis of colorectal cancer in young patients.There is still considerable controversy and debate regarding the features and prognosis of colorectal cancer in young patients.MethodsOne hundred and ten patients (5·1 per cent) under the age of 40 years with colorectal cancer (group Y; male: female ratio 48:62) were compared with 2064 patients with colorectal cancer aged 40 years or more (group O; 917 women, 1147 men). Mode of presentation, stage at diagnosis, tumour characteristics and survival were analysed.One hundred and ten patients (5·1 per cent) under the age of 40 years with colorectal cancer (group Y; male: female ratio 48:62) were compared with 2064 patients with colorectal cancer aged 40 years or more (group O; 917 women, 1147 men). Mode of presentation, stage at diagnosis, tumour characteristics and survival were analysed.ResultsPredisposing malignant conditions and family history of colorectal cancer were present in 20·9 per cent of patients in group Y versus 2·2 per cent in group O (P < 0·001). Common chief complaints included change in bowel habits, bleeding from the rectum and a significantly higher incidence of abdominal pain in group Y. There was no difference in stage at presentation between the two groups (the proportion of Dukes stage A, B, C and ‘D’ lesions in group Y was 8·2, 24·5, 37·3 and 30·0 per cent respectively versus 10·5, 27·9, 33·4 and 28·1 per cent in group O). Tumour site and characteristics were similar in both groups. The incidence of mucinous/signet ring cell and poor grade tumours was 6·9 and 11·8 per cent respectively in group Y and 4·5 and 10·5 per cent in group O. With a mean follow-up of 31·8 months, the overall 5-year survival rate was 54·8 per cent in group Y and 54·1 per cent in group O. Comparing stage for stage, survival was not significantly different in the two groups. However, the adjusted hazard ratios of the age groups Y, M (40–59 years), S (60–79 years), and E (80 years and above) were 1·3, 1 (baseline for calculations), 1·4 and 2·4 respectively, suggesting an adverse outcome for patients in group Y compared with patients aged 40–59 years.Predisposing malignant conditions and family history of colorectal cancer were present in 20·9 per cent of patients in group Y versus 2·2 per cent in group O (P < 0·001). Common chief complaints included change in bowel habits, bleeding from the rectum and a significantly higher incidence of abdominal pain in group Y. There was no difference in stage at presentation between the two groups (the proportion of Dukes stage A, B, C and ‘D’ lesions in group Y was 8·2, 24·5, 37·3 and 30·0 per cent respectively versus 10·5, 27·9, 33·4 and 28·1 per cent in group O). Tumour site and characteristics were similar in both groups. The incidence of mucinous/signet ring cell and poor grade tumours was 6·9 and 11·8 per cent respectively in group Y and 4·5 and 10·5 per cent in group O. With a mean follow-up of 31·8 months, the overall 5-year survival rate was 54·8 per cent in group Y and 54·1 per cent in group O. Comparing stage for stage, survival was not significantly different in the two groups. However, the adjusted hazard ratios of the age groups Y, M (40–59 years), S (60–79 years), and E (80 years and above) were 1·3, 1 (baseline for calculations), 1·4 and 2·4 respectively, suggesting an adverse outcome for patients in group Y compared with patients aged 40–59 years.ConclusionThis study revealed no difference in tumour characteristics and survival in patients with colorectal cancer aged less than 40 years compared with those aged above 40 years. However, a higher hazard ratio in the youngest group may connote a worse prognosis than that for those aged 40–59 years. A significant family history of colorectal cancer and predisposing conditions in the young warrants aggressive screening, surveillance and treatment of the underlying conditions. The detection of colorectal cancer in young patients should be no different from that in the old but demands a high index of suspicion. © 1998 British Journal of Surgery Society LtdThis study revealed no difference in tumour characteristics and survival in patients with colorectal cancer aged less than 40 years compared with those aged above 40 years. However, a higher hazard ratio in the youngest group may connote a worse prognosis than that for those aged 40–59 years. A significant family history of colorectal cancer and predisposing conditions in the young warrants aggressive screening, surveillance and treatment of the underlying conditions. The detection of colorectal cancer in young patients should be no different from that in the old but demands a high index of suspicion. © 1998 British Journal of Surgery Society Ltd
Colorectal cancer in patients aged 30 years or younger
Surgical Oncology-oxford, 1996
Colorectal cancer (CRe) is believed to carry a grim prognosis in young patients. A retrospective study of patients diagnosed with colorectal cancer at age 30 years or less between 1971 and 1994 was conducted. Statistical analyses were performed using non-parametric one way ANOVA tests and logistic regression models. Sixty-eight of the patients evaluated at our institution were suitable for this study. Risk factors were identified in 28% of patients. The median age at diagnosis was 27 years (range 14-30 years). Fifty-six patients (82%) were Stage III or IV at the time of diagnosis. Twenty-two of the 34 patients who underwent potentially curative surgery had recurring disease at a median of 12 months (range 1-43 months). At a median follow-up of 21.5 months, 54 patients had died from disease. At the time of death, abdominal carcinomatosis and distant disease were the most common patterns of failure. Stage of the primary tumour IP = 0.0006) and recurrence (P = 0.0001) were the only variables noted to be associated with survival. The stage of the primary tumour and whether the tumour recurred were each associated with survival in patients with colorectal cancer at age 30 years or less.
Colorectal cancer in patients aged ≤30 years: 17 years of experience
erciyes medical journal, 2019
Objective: Although its incidence has been increasing, colorectal cancer is rare in young patients. There are conflicting reports on its prognosis in young patients with colorectal cancers. The goal of this study is to investigate the prognostic factors in young patients with colorectal cancer. An observational, population-based, retrospective study. Materials and Methods: The clinicopathological characteristics, treatment approaches, and survival data of patients with colorectal cancers aged 30 years and younger were retrospectively analyzed. Results: A total of 32 patients were identified. Hematochezia and abdominal pain were the major signs of colorectal cancer. Left-sided tumors (rectum 53.1%, and left colon 25%) were found to be more common than right-sided (18.8%) and transverse colon tumors (3.1%). Curative surgery was performed in 81.3% of patients. Histologically, 43.8% of cancers found were poorly differentiated. According to the subtype, 21.9% were signet ring cell, and 25% were mucinous (colloid) tumors. Patients were evaluated as Stage III in 46.9% and Stage IV in 31.3% of cases. The 3-year progression-free survival (PFS) was 38.7%, and the 3-year overall survival (OS) was 53.2%. Stage IV disease and disease without curative surgery were poor prognostic factors, both for the OS and PFS. Conclusion: Prognosis was poor in young patients with colorectal cancer. In this institutional study, an advanced stage, left-sided localization, and poor histological feature were frequently detected. The stage and complete surgery were predictive factors for the long-term survival. In this respect, it is important for physicians to heighten their awareness of the increased incidence of colon cancer in younger patients.
Clinicopathological features of colorectal cancer in patients under 40 years of age
International Journal of Colorectal Disease, 2010
Objective. The aim was to identify the clinical factors and tumor characteristics that predict mortality and survival in patients older than 70 years with colorectal adenocarcinoma. Material and methods. One hundred and ninety-four patients with colorectal cancer aged over 70 years were identified from a computer database and their clinical variables were analyzed by both univariate and multivariate analyses. Results. All patients underwent resective surgery, 79% radical and 21% palliative resection, and postoperative mortality was 6% being associated with the presence of postoperative complications, especially anastomotic leakage. The cumulative 5-year survival was 38%, the median survival 35 months, and the cancer-specific 5-year survival 48% and this did not differ significantly between the age groups. The recurrence rate after radical surgery was 30%, being 12, 22, 56, and 100% in Dukes classes A, B, C, and D. Kaplan-Meier estimates indicated that gender, Dukes staging, grade of tumor, number of lymph node metastasis, venous invasion, and recurrent disease were significant predictors of survival, but in the Cox regression model, only venous invasion and recurrent disease were independent prognostic factors of survival. Conclusions. Low mortality and acceptable survival can be achieved in elderly patients with colorectal cancer. Venous invasion and recurrent cancer are independent predictors of survival.
Colorectal Cancer in Patients 30 Years Old and Younger: A 17-Year Experience
Erciyes Medical Journal, 2019
Objective: Although its incidence has been increasing, colorectal cancer is rare in young patients. There are conflicting reports on its prognosis in young patients with colorectal cancers. The goal of this study is to investigate the prognostic factors in young patients with colorectal cancer. An observational, population-based, retrospective study. Materials and Methods: The clinicopathological characteristics, treatment approaches, and survival data of patients with colorectal cancers aged 30 years and younger were retrospectively analyzed. Results: A total of 32 patients were identified. Hematochezia and abdominal pain were the major signs of colorectal cancer. Left-sided tumors (rectum 53.1%, and left colon 25%) were found to be more common than right-sided (18.8%) and transverse colon tumors (3.1%). Curative surgery was performed in 81.3% of patients. Histologically, 43.8% of cancers found were poorly differentiated. According to the subtype, 21.9% were signet ring cell, and 25% were mucinous (colloid) tumors. Patients were evaluated as Stage III in 46.9% and Stage IV in 31.3% of cases. The 3-year progression-free survival (PFS) was 38.7%, and the 3-year overall survival (OS) was 53.2%. Stage IV disease and disease without curative surgery were poor prognostic factors, both for the OS and PFS. Conclusion: Prognosis was poor in young patients with colorectal cancer. In this institutional study, an advanced stage, left-sided localization, and poor histological feature were frequently detected. The stage and complete surgery were predictive factors for the long-term survival. In this respect, it is important for physicians to heighten their awareness of the increased incidence of colon cancer in younger patients.
Influence of age on prognosis and management of patients with colorectal carcinoma
European Journal of Surgery, 1999
Objective: To see if the prognosis and management differed in patients with carcinoma of colon and rectum above and below 65 years of age. Design: Retrospective study. Setting: University hospital, Turkey. Subjects: 822 consecutive patients with colorectal carcinoma operated on between 1984 and 1994, 565 of whom were less than 65, and 257 of whom were 65 or more.
Turkish Journal of Colorectal Disease
Aim: The incidence of colorectal tumors in young patients has been rising lately, and current investigations are directed to determine causes and prognosis of this type of patients. The objective of this publication is to analyze results of surgical treatment and tumor stages in young patients, and compare them to those in older individuals. Method: A retrospective analysis of patients undergoing surgery for colorectal adenocarcinoma during 2015-2020 in a single institution was performed, dividing them into two categories: those younger than 50 years old, early onset colorectal cancer (EOCRC), and those on age for colorectal cancer screening, average onset colorectal cancer (AOCRC), focusing on disease stage and postoperative outcomes. Results: Two hundred and seven patients were included, thirty-two in the EOCRC group. Median age was 42.10 years (SD= 5.74) and 65.38 years (SD= 7.19) respectively, dyslipidemia was more prevalent in AOCRC patients. EOCRC patients had more upper rectum (28.13 vs. 8%, p= 0,001) and transverse colon (21.88 vs. 10.29%, p=0.06) tumors, had higher rates of complications (43.75 vs. 28%, p=0.07) and reoperations (18.75 vs. 7.43%, p=0.04). Moreover, major complications were more frequent in younger patients. EOCRC had significantly more stage IV tumors (18.75 vs. 5.13 %, p=0,01), and 46.86% of these individuals had an advanced disease at the time of surgery. Conclusion: EOCRC is diagnosed at more advanced stages of the disease and presents differences in tumor location. Complications including need of reoperation are more frequent in this group.
Outcome of surgical treatment of colorectal cancer in the elderly
Updates in Surgery
The aim of this study is to compare the clinical features and the perioperative and long-term outcomes after primary surgery for colorectal cancer (CRC) in the elderly population with those observed in younger patients. All the patients over the age of 55 who underwent primary surgery for CRC in our clinic from 1988 to 2008 were included in this study and divided into two age groups: 55–75 and >75 years considering the age of diagnosis. 914 consecutive patients were enrolled in the study (352 > 75 years). In the elderly group, tumors were predominantly right sided, and the overall number of comorbidities was statistical more frequent. Elderly patients underwent emergency surgery more than the control group (p = 0.0008). There were no significant differences between the two groups in terms of curative and palliative resections. The overall operative mortality rate was 5.9% in the study group compared with 2.1% in the control study (p = 0.0033). The overall 3-year, 5-year and 10-year survival rates were, respectively, 37, 16.2 and 5.1% in the study group, when compared with 52.3, 35.1 and 24.7% in the control group (p = 0.022, p = 0.0001 and p = 0.0001, respectively). More patients were lost during the follow-up in the elderly group (p = 0.0003) and more deaths unrelated to cancer were found in the study group compared with the control group (p = 0.0005). The cancer specific mortality was similar between the two groups. In conclusion, elderly patients that underwent major colorectal resection have an acceptable perioperative morbidity, mortality and survival rate when compared with younger patients. Age alone should not be considered a reason to deny surgery to these patients.