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International Journal of Colorectal Disease

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01-08-2017 | Original Article

Poor prognosis of young patients with colorectal cancer: a retrospective study

Authors: Liying Zhao, Feng Bao, Jun Yan, Hao Liu, Tingting Li, Hao Chen, Guoxin Li

Published in: International Journal of Colorectal Disease | Issue 8/2017

Abstract

Purpose

The present study aimed to explore the survival outcomes of patients with colorectal cancer (CRC) aged 35 years and younger.

Methods

This retrospective cohort study included a total of 995 patients with CRC treated between January 2003 and September 2011. The patients were assorted into the young (aged 18–35 years) and older (aged 36–75 years) groups. The clinical characteristics and survival outcomes of the patients in the young group were compared with those of the patients in the older group for evaluation.

Results

Compared with the older group, a significantly higher number of patients in the young group had right-sided colon cancer (30.9 vs. 19.6%, P = 0.026), high histologic grade tumor (14.7 vs. 6.4%, P = 0.021), and stage III disease (50.0 vs. 35.5%, P = 0.016). In stage III disease, compared with the older group, the patients in the young group had worse survival outcome in terms of 5-year overall survival (OS, P = 0.007), cancer-specific survival (CSS, P = 0.010), and disease-free survival (DFS, P = 0.039). Multivariate analysis revealed that age ≤35 years was an independent risk factor in terms of 5-year OS (hazard ratio [HR] = 1.68; 95% confidence interval [CI]: 1.12–2.54; P = 0.012), CSS (HR = 1.74; 95% CI: 1.15–2.65; P = 0.009), and DFS (HR = 1.58; 95% CI: 1.06–2.35; P = 0.024).

Conclusions

The young patients with CRC aged 35 years and younger had worse prognosis compared with older patients, especially for stage III disease.

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Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics, 2012. CA Cancer J Clin 65(2):87–108. doi:10.3322/caac.21262 CrossRefPubMed

Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J (2016) Cancer statistics in China, 2015. CA Cancer J Clin 66(2):115–132. doi:10.3322/caac.21338

Edwards BK, Ward E, Kohler BA, Eheman C, Zauber AG, Anderson RN, Jemal A, Schymura MJ, Lansdorp-Vogelaar I, Seeff LC, van Ballegooijen M, Goede SL, Ries LA (2010) Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer 116(3):544–573. doi:10.1002/cncr.24760 CrossRefPubMedPubMedCentral

Ahnen DJ, Wade SW, Jones WF, Sifri R, Mendoza Silveiras J, Greenamyer J, Guiffre S, Axilbund J, Spiegel A, You YN (2014) The increasing incidence of young-onset colorectal cancer: a call to action. Mayo Clin Proc 89(2):216–224. doi:10.1016/j.mayocp.2013.09.006 CrossRefPubMed

You YN, Xing Y, Feig BW, Chang GJ, Cormier JN (2012) Young-onset colorectal cancer: is it time to pay attention? Arch Intern Med 172(3):287–289. doi:10.1001/archinternmed.2011.602 CrossRefPubMed

Wu QJ, Vogtmann E, Zhang W, Xie L, Yang WS, Tan YT, Gao J, Xiang YB (2012) Cancer incidence among adolescents and young adults in urban Shanghai, 1973–2005. PLoS One 7(8):e42607. doi:10.1371/journal.pone.0042607 CrossRefPubMedPubMedCentral

Pourhoseingholi MA (2012) Increased burden of colorectal cancer in Asia. World journal of gastrointestinal oncology 4(4):68–70. doi:10.4251/wjgo.v4.i4.68 CrossRefPubMedPubMedCentral

Sineshaw HM, Robbins AS, Jemal A (2014) Disparities in survival improvement for metastatic colorectal cancer by race/ethnicity and age in the United States. Cancer causes & control : CCC 25(4):419–423. doi:10.1007/s10552-014-0344-z CrossRefPubMed

Ashktorab H, Paydar M, Namin HH, Sanderson A, Begum R, Brim H, Panchal H, Lee E, Kibreab A, Nouraie M, Laiyemo AO (2014) Prevalence of colorectal neoplasia among young African Americans and Hispanic Americans. Dig Dis Sci 59(2):446–450. doi:10.1007/s10620-013-2898-0 CrossRefPubMed

10.

Chan KK, Dassanayake B, Deen R, Wickramarachchi RE, Kumarage SK, Samita S, Deen KI (2010) 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. World journal of surgical oncology 8:82. doi:10.1186/1477-7819-8-82 CrossRefPubMedPubMedCentral

11.

Kaplan MA, Isikdogan A, Gumus M, Arslan UY, Geredeli C, Ozdemir N, Koca D, Dane F, Suner A, Elkiran ET, Kucukoner M, Seker M, Helvaci K, Guler T, Uncu D, Inal A, Yildiz R (2013) Childhood, adolescents, and young adults (</=25 y) colorectal cancer: study of Anatolian Society of Medical Oncology. J Pediatr Hematol Oncol 35(2):83–89. doi:10.1097/MPH.0b013e31827e7f20 CrossRefPubMed

12.

Li M, Li JY, Zhao AL, Gu J (2011) Do young patients with colorectal cancer have a poorer prognosis than old patients? J Surg Res 167(2):231–236. doi:10.1016/j.jss.2010.10.040 CrossRefPubMed

13.

Taggarshe D, Rehil N, Sharma S, Flynn JC, Damadi A (2013) Colorectal cancer: are the “young” being overlooked? Am J Surg 205(3):312–316; discussion 316. doi:10.1016/j.amjsurg.2012.10.016

14.

Yeo SA, Chew MH, Koh PK, Tang CL (2013) Young colorectal carcinoma patients do not have a poorer prognosis: a comparative review of 2,426 cases. Techniques in coloproctology 17 (6):653–661. doi:10.1007/s10151-013-0977-z

15.

Liang YZ, Yu J, Zhang C, Wang YN, Cheng X, Huang F, Li GX (2010) Construction and application of evaluation system of laparoscopic colorectal surgery based on clinical data mining. Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 13(10):741–744. doi:10.3760/cma.j.issn.1671-0274.2010.10.007

16.

Ueno H, Mochizuki H, Akagi Y, Kusumi T, Yamada K, Ikegami M, Kawachi H, Kameoka S, Ohkura Y, Masaki T, Kushima R, Takahashi K, Ajioka Y, Hase K, Ochiai A, Wada R, Iwaya K, Shimazaki H, Nakamura T, Sugihara K (2012) Optimal colorectal cancer staging criteria in TNM classification. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 30(13):1519–1526. doi:10.1200/JCO.2011.39.4692 CrossRef

17.

Huh JW, Kim YJ, Kim HR (2012) Distribution of lymph node metastases is an independent predictor of survival for sigmoid colon and rectal cancer. Ann Surg 255(1):70–78. doi:10.1097/SLA.0b013e31823785f6 CrossRefPubMed

18.

Al-Barrak J, Gill S (2011) Presentation and outcomes of patients aged 30 years and younger with colorectal cancer: a 20-year retrospective review. Med Oncol 28(4):1058–1061. doi:10.1007/s12032-010-9639-4

19.

Enblad G, Enblad P, Adami HO, Glimelius B, Krusemo U, Pahlman L (1990) Relationship between age and survival in cancer of the colon and rectum with special reference to patients less than 40 years of age. The British journal of surgery 77(6):611–616. doi:10.1002/bjs.1800770605

20.

Kam MH, Eu KW, Barben CP, Seow-Choen F (2004) Colorectal cancer in the young: a 12-year review of patients 30 years or less. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 6(3):191–194. doi:10.1111/j.1463-1318.2004.00596.x

21.

McMillan DC, McArdle CS (2009) The impact of young age on cancer-specific and non-cancer-related survival after surgery for colorectal cancer: 10-year follow-up. Br J Cancer 101(4):557–560. doi:10.1038/sj.bjc.6605222 CrossRefPubMedPubMedCentral

22.

Rodriguez-Bigas MA, Mahoney MC, Weber TK, Petrelli NJ (1996) Colorectal cancer in patients aged 30 years or younger. Surg Oncol 5(4):189–194. doi:10.1016/S0960-7404(96)80043-0

23.

Fu JF, Huang YQ, Yang J, Yi CH, Chen HL, Zheng S (2013) Clinical characteristics and prognosis of young patients with colorectal cancer in Eastern China. World journal of gastroenterology : WJG 19(44):8078–8084. doi:10.3748/wjg.v19.i44.8078 CrossRefPubMedPubMedCentral

24.

Ciarrocchi A, Amicucci G (2013) Sporadic carcinoma of the colon-rectum in young patients: a distinct disease? A critical review. Journal of gastrointestinal cancer 44(3):264–269. doi:10.1007/s12029-013-9507-5 CrossRefPubMed

25.

Ganapathi S, Kumar D, Katsoulas N, Melville D, Hodgson S, Finlayson C, Hagger R (2011) Colorectal cancer in the young: trends, characteristics and outcome. Int J Color Dis 26(7):927–934. doi:10.1007/s00384-011-1174-z CrossRef

26.

Xu A-G (2010) Colorectal cancer in Guangdong Province of China: a demographic and anatomic survey. World J Gastroenterol 16(8):960. doi:10.3748/wjg.v16.i8.960 CrossRefPubMedPubMedCentral

27.

Shemesh-Bar L, Kundel Y, Idelevich E, Sulkes J, Sulkes A, Brenner B (2010) Colorectal cancer in young patients in Israel: a distinct clinicopathological entity? World J Surg 34(11):2701–2709. doi:10.1007/s00268-010-0748-1 CrossRefPubMed

28.

Lo AC, Soliman AS, Khaled HM, Aboelyazid A, Greenson JK (2010) Lifestyle, occupational, and reproductive factors and risk of colorectal cancer. Dis Colon rectum 53 (5):830–837. doi:10.1007/DCR.0b013e3181d320b1

29.

Morrison DS, Batty GD, Kivimaki M, Davey Smith G, Marmot M, Shipley M (2011) Risk factors for colonic and rectal cancer mortality: evidence from 40 years’ follow-up in the Whitehall I study. J Epidemiol Community Health 65(11):1053–1058. doi:10.1136/jech.2010.127555

30.

Ghazi S, Lindforss U, Lindberg G, Berg E, Lindblom A, Papadogiannakis N, Low-Risk Colorectal Cancer Study G (2012) Analysis of colorectal cancer morphology in relation to sex, age, location, and family history. J Gastroenterol 47(6):619–634. doi:10.1007/s00535-011-0520-9 CrossRefPubMed

31.

Schellerer VS, Merkel S, Schumann SC, Schlabrakowski A, Fortsch T, Schildberg C, Hohenberger W, Croner RS (2012) Despite aggressive histopathology survival is not impaired in young patients with colorectal cancer : CRC in patients under 50 years of age. Int J Color Dis 27(1):71–79. doi:10.1007/s00384-011-1291-8

32.

Chiang JM, Yeh CY, Changchien CR, Chen JS, Tang R, Chen JR (2010) Mucinous adenocarcinoma showing different clinicopathological and molecular characteristics in relation to different colorectal cancer subgroups. Int J Color Dis 25(8):941–947. doi:10.1007/s00384-010-0958-x CrossRef

33.

Yamaguchi T, Taniguchi H, Fujita S, Sekine S, Yamamoto S, Akasu T, Kushima R, Tani T, Moriya Y, Shimoda T (2012) Clinicopathological characteristics and prognostic factors of advanced colorectal mucinous adenocarcinoma. Histopathology 61(2):162–169. doi:10.1111/j.1365-2559.2012.04235.x CrossRefPubMed

34.

Chou CL, Chang SC, Lin TC, Chen WS, Jiang JK, Wang HS, Yang SH, Liang WY, Lin JK (2011) Differences in clinicopathological characteristics of colorectal cancer between younger and elderly patients: an analysis of 322 patients from a single institution. Am J Surg 202(5):574–582. doi:10.1016/j.amjsurg.2010.10.014 CrossRefPubMed

35.

Cerdan-Santacruz C, Cano-Valderrama O, Cardenas-Crespo S, Torres-Garcia AJ, Cerdan-Miguel J (2011) Colorectal cancer and its delayed diagnosis: have we improved in the past 25 years? Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 103(9):458–463. doi:10.4321/S1130-01082011000900004

36.

Serra-Rexach JA, Jimenez AB, Garcia-Alhambra MA, Pla R, Vidan M, Rodriguez P, Ortiz J, Garcia-Alfonso P, Martin M (2012) Differences in the therapeutic approach to colorectal cancer in young and elderly patients. Oncologist 17(10):1277–1285. doi:10.1634/theoncologist.2012-0060 CrossRefPubMedPubMedCentral

37.

Doat S, Thiebaut A, Samson S, Ricordeau P, Guillemot D, Mitry E (2014) Elderly patients with colorectal cancer: treatment modalities and survival in France. National data from the ThInDiT cohort study. Eur J Cancer 50(7):1276–1283. doi:10.1016/j.ejca.2013.12.026 CrossRefPubMed

38.

Bailey CE, Hu CY, You YN, Bednarski BK, Rodriguez-Bigas MA, Skibber JM, Cantor SB, Chang GJ (2015) Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975–2010. JAMA surgery 150(1):17–22. doi:10.1001/jamasurg.2014.1756 CrossRefPubMedPubMedCentral

39.

Li Q, Zhuo C, Cai G, Zheng H, Li D, Cai S (2014) Pathological features and survival outcomes of young patients with operable colon cancer: are they homogeneous? PLoS One 9(7):e102004. doi:10.1371/journal.pone.0102004 CrossRefPubMedPubMedCentral

Title: Poor prognosis of young patients with colorectal cancer: a retrospective study
Authors: Liying Zhao
Feng Bao
Jun Yan
Hao Liu
Tingting Li
Hao Chen
Guoxin Li
Publication date: 01-08-2017
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 8/2017
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-017-2809-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Poor prognosis of young patients with colorectal cancer: a retrospective study

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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