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BMC Cancer
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

Shorter survival in adolescent and young adult patients, compared to adult patients, with stage IV colorectal cancer in Japan

Authors: Dai Shida, Yuka Ahiko, Taro Tanabe, Takefumi Yoshida, Shunsuke Tsukamoto, Hiroki Ochiai, Atsuo Takashima, Narikazu Boku, Yukihide Kanemitsu

Published in: BMC Cancer | Issue 1/2018

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Abstract

Background

The incidence of colorectal cancer in adolescent and young adult patients is increasing. However, survival and clinical features of young patients, especially those with stage IV disease, relative to adult patients remain unclear.

Methods

This retrospective single-institution cohort study was conducted at a tertiary care cancer center. Subjects were 861 consecutive patients who were diagnosed with stage IV colorectal cancer at the age of 15 to 74 years and who were referred to the division of surgery or gastrointestinal oncology at the National Cancer Center Hospital from 1999 to 2013. Overall survival (OS) was investigated and clinicopathological variables were analyzed for prognostic significance.

Results

Of these, 66 (8%) were adolescent and young adult patients and 795 (92%) were adult patients. Median survival time was 13.6 months in adolescent and young adult patients and 22.4 months in adult patients, and 5-year OS rates were 17.3% and 20.3%, respectively, indicating significant worse prognosis of adolescent and young adult patients (p = 0.042). However, age itself was not an independent factor associated with prognosis by multivariate analysis. When compared with adult patients, adolescent and young adult patients consisted of higher proportion of the patients who did not undergo resection of primary tumor, which was an independent factor associated with poor prognosis in multivariate analysis. In patients who did not undergo resection (n = 349), OS of adolescent and young adult patients were significantly worse (p = 0.033).

Conclusions

Prognoses were worse in adolescent and young adult patients with stage IV colorectal cancer compared to adult patients in Japan, due to a higher proportion of patients who did not undergo resection with more advanced and severe disease, but not due to age itself.
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Metadata
Title
Shorter survival in adolescent and young adult patients, compared to adult patients, with stage IV colorectal cancer in Japan
Authors
Dai Shida
Yuka Ahiko
Taro Tanabe
Takefumi Yoshida
Shunsuke Tsukamoto
Hiroki Ochiai
Atsuo Takashima
Narikazu Boku
Yukihide Kanemitsu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-4241-9

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