Prognostic factors after surgery in patients younger than 50 years old with colorectal adenocarcinoma.
OBJECTIVE
The factors predicting recurrence and survival were evaluated using a computer-generated database to identify the independent predictors of survival of colorectal cancer in patients under 50 years of age.


METHODS
One hundred and two patients under the age of 50 years with colorectal cancer who had been admitted into our hospital during the 20-year period of 1980-1999 were identified from a computer database. The factors possibly predicting recurrence were compared by bivariate analysis and the predictors of long-term survival by both univariate and multivariate analysis.


RESULTS
A family history of colorectal cancer was present in 14% of all patients and in 15% of the patients aged under 40 years. Overall 5-year survival after radical resection was 59% and median survival 47 months. The recurrence rate after radical resection was 40%, being 13%, 35%, 55% and 80% in Dukes classes A, B, C and D, respectively. The risk of recurrence was most closely related to lymphatic invasion, vascular invasion and Dukes stage. Kaplan-Meier estimates showed that Dukes stage, grade of tumor, venous invasion, lymphatic invasion, perineural invasion and radicality of resection were the best predictors of survival, but in multivariate analysis only the radicality of operation, venous invasion and tumor grade retained their significance.


CONCLUSIONS
Young age is not a poor prognostic marker in colorectal cancer. In addition to radical operation, venous invasion and tumor grade are good predictors of survival in patients under the age of 50 years.
Mäkelä
Jyrki
J
Department of Surgery, Division of Gastroenterology, University of Oulu, Kajaanintie 52 A, FIN-90220 Oulu, Finland.
Kiviniemi
Heikki
H
Laitinen
Seppo
S
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating; D011379:Prognosis; D016019:Survival Analysis; D017741:Survivors