Characteristics and prognosis of colorectal cancer in patients under 35 years of age

Li-Ying Zhao, MD, Feng Bao, MD, Hao Liu, MD, PhD, Tian Lin, Jun Yan, MD, PhD, Guo-Xin Li, MD, PhD. General surgery

INTRODUCTION: To explore the clinical characteristics and the prognosis of young patients with colorectal cancer.

METHODS: This retrospective cohort study enrolled a total of 995 patients with colorectal cancer who underwent curative surgery between January 2003 and September 2009 in Nanfang Hospital, Southern Medical University. Patients with family history were excluded. Patients were divided into two groups according to the age (group A: aged 18-35 years; group B: aged 36-75 years). The clinical characteristics and survival outcomes of the patients in Group A were evaluated by comparing those with the patients in group B.

RESULTS: There were 68 (6.8%) and 927 (93.2%) patients in thegroup A and group B, respectively. Compared with the group B, significantly more patients in the group A had right-sided colon cancer (30.9% vs.19.6%, P = 0.026), mucinous tumor (13.2% vs.5.9%, P = 0.034), poorly differentiated tumor (16.2% vs.4.9%, P<0.001), and stage III disease (50.0% vs.35.5%, P = 0.016). The 5-year overall survival (OS), cancer specific survival (CSS), and disease-free survival (DFS) in the group A and group B were 66.4% vs. 75.8% (P=0.010), 68.2% vs.77.1% (P=0.008), and 58.6% vs. 71.7% (P=0.023), respectively. Multivariate analysis revealed that age ≤ 35 years was an independent factor for the prognosis of 5-year OS (OR=1.76, 95%CI:1.09-2.84, P=0.020), CSS (OR=1.96, 95%CI:1.21-3.17, P=0.006), and DFS (OR=1.62, 95%CI:1.02-2.58, P=0.041). Subgroup analysis showed that patients with stage III disease had worse survival outcomes in the group A than in the group B in the aspects of 5-year OS, CSS, and DFS.

CONCLUSION: The prognosis of the colorectal patient aged 35 years or younger was worse than the older patients, especially in the stage III disease.


Partial Figures 5-year survival outcomes of patients in the group A (≤ 35 years) and group B (36-75 years) underwent curative surgery by stage.

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