Differences in clinicopathological characteristics of colorectal cancer between younger and elderly patients: an analysis of 322 patients from a single institution (original) (raw)
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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.
International Journal of Advances in Medicine
Background: Colorectal cancer (CRC) is a common cancer worldwide with significant geographical variation in its incidence. CRC among young adults is not well reported in Indian patients.Methods: A retrospective study was performed to determine the burden and to analyze the clinicopathological characteristics of newly diagnosed CRC among younger adults (<50 years). Chi-square method was used to analyze the clinicopathological characteristics. P≤0.05 was considered statistically significant.Results: CRC among younger adults comprised 40.3% of total patients median age of 40 years at diagnosis, was associated with predominantly male patients with male: female ratio of 1.8:1, positive family history, lesser co-morbidities (p=0.000), majority left sided primary tumor with left: right ratio of 4.6:1, more frequent high grade histology compared to older age group (p=0.000), advanced primary tumor and nodal metastasis. Approximately one third patients had distant metastasis at diagnosis ...
Colorectal carcinoma in different age groups
International Journal of Colorectal Disease, 2000
Purpose Although colorectal cancer is typical in the older population, tumor onset before age 40 is not infrequent. However, the behavior, characteristics, and prognosis of this disease in young patients are unclear when compared to the older population. It is believed that young patients have a poor prognosis. We hypothesized that young patients have a poor prognosis because they have advanced-stage
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.
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
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.
Colorectal cancer in patients aged less than 40 years
The Journal of the American Board of Family Practice / American Board of Family Practice
Colorectal cancer is commonly found in adults aged greater than 50 years. The peak frequency occurs in the 6th to 7th decades and gradually declines in the 8th decade. This cancer is very unusual in young adults, the occurrence ranging from 1 to 17 percent of all cases of colon cancer. The prognosis for this disease in the young adult is reported to be unfavorable. This may be due to delayed diagnoses and a higher frequency of mucin-producing tumors and advanced stage of the disease. This article presents a case report and review of the literature and alerts the primary care physician to the possibility of serious disease in young adults who may present with protracted abdominal symptoms. Age should not be a barrier in the application of diagnostic tools. The duration and degree of symptoms should prompt early investigation.
Age wise distribution of colorectal cancer: An institutional observational study
IOSR Journal of Dental and Medical Sciences, 2017
Background: Overall, the incidence of colorectal cancer appears to be stable or diminishing. However, based on our regional cancer institute's datas, we have observed the increasing incidence of colorectal cancer in patients ≤40 age. The aim of this study was to verify the rising trend, clinico-pathological features and survival in colorectal cancer in patients ≤40,in comparison to patients >40 age. Materials and methods: A retrospective study was conducted to review all patients≤ 40 age and more than 40 year of age separatly with a diagnosis of colorectal cancer from January 2004 to December 2012. Results: Young patients were 24.17% of total 1096 colorectal cases. In young patients 60.37% were male and 39.63% were female. 9% young had family history & only 8% had history of alcohol intake. Onset of symptoms to reaching diagnosis period is longer in younger patients.(Range 3 months to 1 year in young, while 1 months to 6 months in older). Higher pathological T stage was seen in the younger age group when compared with patients above 40 years. Also the younger age group showed more advanced N stage when compared with patients above 40 years. With final TNM staging, in younger age group 66% were in stage IV and 30% were in stage III. Eighty percent of all young cancer deaths were within 22 months (from 8months to 22 months). Conclusion: Above results show the aggressive nature and late diagnosis of carcinoma colorectal in young. These data highlight a need for thorough evaluation of young with colorectal symptoms and in high risk population, also life style modification agenda by Govt .or non Govt. organization.
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.