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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2007

01-10-2007 | Gastrointestinal Oncology

Young Age Influences Treatment but not Outcome of Colon Cancer

Authors: H. M. Quah, R. Joseph, D. Schrag, J. Shia, J. G. Guillem, P. B. Paty, L. K. Temple, W. D. Wong, M. R. Weiser

Published in: Annals of Surgical Oncology | Issue 10/2007

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Abstract

Background

Early age at onset is often considered a poor prognostic factor for colon cancer. The aim of this study was to determine the association between age, clinicopathologic features, adjuvant therapy, and outcomes following colon cancer resection.

Methods

A prospective database of 1327 surgical stage I–III colon cancer patients operated on from 1990–2001 was evaluated, and patients grouped by age.

Results

Sixty-eight patients (5%) were diagnosed at age ≤40 years (younger) compared with 1259 patients diagnosed at age >40 (older). Younger patients were more likely to have left-sided tumors (66% vs 51%, P = .02), but no more likely to present with symptomatic lesions, more advanced tumors, or have worse pathologic features. Younger patients were noted to have more nodes retrieved in their surgical specimens than older patients (median 18 vs 14, P = .001), although the numbers of total colectomies were similar in both groups. Younger patients were also more likely to receive adjuvant chemotherapy, and this was most pronounced in the stage II cohort: 39% vs 14%, P = .003. With a median follow-up of 55 months, 5-year disease-specific survival (DSS) was similar in both study groups: 86% vs 87%, but 5-year overall survival (OS) was significantly higher in the younger patient cohort (84% vs 73%, P = .001).

Conclusion

Younger patients undergoing complete resection of stage I–III colon cancer had DSS similar to older patients. However, younger patients had more nodes retrieved from their specimens and were more likely to receive adjuvant therapy, especially for node-negative disease. These factors may have contributed to their overall favorable outcome.
Literature
1.
American Cancer Society. Cancer Facts, Figures 2006. Atlanta, GA: American Cancer Society; 2006
2.
O’Connell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY. Rates of colon and rectal cancers are increasing in young adults. Am Surg 2003; 69:866–72PubMed
3.
Lee PY, Fletcher WS, Sullivan ES, Vetto JT. Colorectal cancer in young patients: characteristics and outcome. Am Surg 1994; 60:607–12PubMed
4.
Leff DR, Chen A, Roberts D, et al. Colorectal cancer in the young patient. Am Surg 2007; 73:42–7PubMed
5.
Lin JT, Wang WS, Yen CC, et al. Outcome of colorectal carcinoma in patients under 40 years of age. J Gastroenterol Hepatol 2005; 20:900–5PubMedCrossRef
6.
Minardi AJ, Jr., Sittig KM, Zibari GB, McDonald JC. Colorectal cancer in the young patient. Am Surg 1998; 64:849–53PubMed
7.
Bedikian AY, Kantarjian H, Nelson RS, Stroehlein JR, Bodey GP. Colorectal cancer in young adults. South Med J 1981; 74:920–4PubMed
8.
Chiang JM, Chen MC, Changchien CR, et al. Favorable influence of age on tumor characteristics of sporadic colorectal adenocarcinoma: patients 30 years of age or younger may be a distinct patient group. Dis Colon Rectum 2003; 46:904–10PubMedCrossRef
9.
Cusack JC, Giacco GG, Cleary K, et al. Survival factors in 186 patients younger than 40 years old with colorectal adenocarcinoma. J Am Coll Surg 1996; 183:105–12PubMed
10.
Griffin PM, Liff JM, Greenberg RS, Clark WS. Adenocarcinomas of the colon and rectum in persons under 40 years old. A population-based study. Gastroenterology 1991; 100:1033–40PubMed
11.
Liang JT, Huang KC, Cheng AL, Jeng YM, Wu MS, Wang SM. Clinicopathological and molecular biological features of colorectal cancer in patients less than 40 years of age. Br J Surg 2003; 90:205–14PubMedCrossRef
12.
Soliman AS, Bondy ML, Levin B, et al. Colorectal cancer in Egyptian patients under 40 years of age. Int J Cancer 1997; 71:26–30PubMedCrossRef
13.
D’Onofrio GM, Tan EG. Is colorectal carcinoma in the young a more deadly disease? Aust N Z J Surg 1985; 55:537–40PubMed
14.
Domergue J, Ismail M, Astre C, et al. Colorectal carcinoma in patients younger than 40 years of age. Montpellier Cancer Institute experience with 78 patients. Cancer 1988; 61:835–40PubMedCrossRef
15.
Okuno M, Ikehara T, Nagayama M, Sakamoto K, Kato Y, Umeyama K. Colorectal carcinoma in young adults. Am J Surg 1987; 154:264–8PubMedCrossRef
16.
Smith C, Butler JA. Colorectal cancer in patients younger than 40 years of age. Dis Colon Rectum 1989; 32:843–6PubMedCrossRef
17.
Makela J, Kiviniemi H, Laitinen S. Prognostic factors after surgery in patients younger than 50 years old with colorectal adenocarcinoma. Hepatogastroenterology 2002; 49:971–5PubMed
18.
Mitry E, Benhamiche AM, Jouve JL, Clinard F, Finn-Faivre C, Faivre J. Colorectal adenocarcinoma in patients under 45 years of age: comparison with older patients in a well-defined French population. Dis Colon Rectum 2001; 44:380–7PubMedCrossRef
19.
O’Connell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY. Do young colon cancer patients have worse outcomes? World J Surg 2004; 28:558–62PubMedCrossRef
20.
Paraf F, Jothy S. Colorectal cancer before the age of 40: a case-control study. Dis Colon Rectum 2000; 43:1222–6PubMedCrossRef
21.
Turkiewicz D, Miller B, Schache D, Cohen J, Theile D. Young patients with colorectal cancer: how do they fare? ANZ J Surg 2001; 71:707–10PubMedCrossRef
22.
Chung YF, Eu KW, Machin D, et al. Young age is not a poor prognostic marker in colorectal cancer. Br J Surg 1998; 85:1255–9PubMedCrossRef
23.
Nelson H, Petrelli N, Carlin A, et al. Guidelines 2000 for colon and rectal cancer surgery. J Natl Cancer Inst 2001; 93:583–96PubMedCrossRef
24.
AJCC Cancer Staging Manual. 6th ed. Springer-Verlag: New York, NY; 2002
25.
Bowne WB, Lee B, Wong WD, et al. Operative salvage for locoregional recurrent colon cancer after curative resection: an analysis of 100 cases. Dis Colon Rectum 2005; 48:897–909PubMedCrossRef
26.
Vasen HF, Watson P, Mecklin JP, Lynch HT. New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome) proposed by the International Collaborative group on HNPCC. Gastroenterology 1999; 116:1453–6PubMedCrossRef
27.
Efficacy of adjuvant fluorouracil and folinic acid in B2 colon cancer. International Multicentre Pooled Analysis of B2 Colon Cancer Trials (IMPACT B2) Investigators. J Clin Oncol 1999; 17:1356–63
28.
Schrag D, Rifas-Shiman S, Saltz L, Bach PB, Begg CB. Adjuvant chemotherapy use for Medicare beneficiaries with stage II colon cancer. J Clin Oncol 2002; 20:3999–4005PubMedCrossRef
29.
NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA 1990; 264:1444–50
30.
Sarli L, Bader G, Iusco D, et al. Number of lymph nodes examined and prognosis of TNM stage II colorectal cancer. Eur J Cancer 2005; 41:272–9PubMedCrossRef
31.
Chen SL, Bilchik AJ. More Extensive Nodal Dissection Improves Survival for Stages I to III of Colon Cancer: A Population-Based Study. Ann Surg 2006; 244:602–10PubMed
32.
Le Voyer TE, Sigurdson ER, Hanlon AL, et al. Colon cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of intergroup trial INT-0089. J Clin Oncol 2003; 21:2912–9PubMedCrossRef
33.
Gryfe R, Kim H, Hsieh ET, et al. Tumor microsatellite instability and clinical outcome in young patients with colorectal cancer. N Engl J Med 2000; 342:69–77PubMedCrossRef
34.
Ribic CM, Sargent DJ, Moore MJ, et al. Tumor microsatellite-instability status as a predictor of benefit from fluorouracil-based adjuvant chemotherapy for colon cancer. N Engl J Med 2003; 349:247–57PubMedCrossRef
Metadata
Title
Young Age Influences Treatment but not Outcome of Colon Cancer
Authors
H. M. Quah
R. Joseph
D. Schrag
J. Shia
J. G. Guillem
P. B. Paty
L. K. Temple
W. D. Wong
M. R. Weiser
Publication date
01-10-2007
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-007-9465-x

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