Improved survival in an Asian cohort of young colorectal cancer patients: an analysis of 523 patients from a single institution.
BACKGROUND
Colorectal cancer (CRC) in the young is rare. Outcomes remain varied compared to older populations. The study reviews characteristics and overall survival (OS) of CRC in patients < or =50 years old.


METHODS
Five hundred and twenty-three (14%) of 3,796 sporadic CRCs were identified. Patients were compared for demographics, tumour characteristics, treatment, and 5-year overall specific survival. Independent prognostic factors were evaluated.


RESULTS
The majority were males (54%) with a median age of 45 years (range 19-50 years). Sixty-three percent of the patients presented with advanced stage disease (stage III and IV), and tumours were predominantly left-sided (83%). A higher frequency of mucinous or signet ring cell histological subtypes (16% vs 9%, p = 0.028) as well as poorly differentiated tumours (30% vs 12%, p = 0.0001) were present in younger patients < or =40 years. With a median follow-up of 41 months, the 5-year OS is 58% (95% confidence interval 53-64%). Younger patients < or =40 years had significantly superior 5-year OS of 62% vs 58% in the age group 41-50 years old (p = 0.004). Multivariate analysis identified five independent prognostic features: age group of 41-50 years, poorly differentiated tumour grade, presence of perineural infiltration, high tumour stage, and carcinoembryonic antigen values > or =5 ng/ml.


CONCLUSIONS
This study has revealed significantly improved 5-year survival in young CRC compared to those reported in the literature.
Chew
Min-Hoe
MH
Department of Colorectal Surgery, Singapore General Hospital, Singapore 169608, Singapore.
Koh
Poh-Koon
PK
Ng
Kheng-Hong
KH
Eu
Kong-Weng
KW
D000328:Adult; D000367:Age Factors; D001208:Asia; D002272:Carcinoembryonic Antigen; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult
D002272:Carcinoembryonic Antigen