The impact of young age on cancer-specific and non-cancer-related survival after surgery for colorectal cancer: 10-year follow-up.
BACKGROUND
It has been reported that although young patients present with more advanced disease, when adjusted for stage, cancer-specific survival is not different after surgery for colorectal cancer. However, few studies have examined non-cancer survival in young patients and 10-year survival has rarely been reported. Moreover, the largest study included patients of old age as a comparator. The aim of this study was to compare cancer-specific and non-cancer-related survival at 10 years in a young age cohort and a middle age cohort in patients undergoing surgery for colorectal cancer.


METHODS
Two thousand and seventy seven patients who underwent surgery for colorectal cancer between 1991 and 1994 in 11 hospitals in Scotland were included in the study. Ten-year cancer-specific and non-cancer-related survival and the hazard ratios (HR) were calculated according to age groups (<45/45-54/55-64/65-74 years).


RESULTS
On follow-up, 1066 patients died of their cancer and 369 died of non-cancer-related causes. At 10 years, overall survival was 32%, cancer-specific was 45%, and non-cancer-related survival was 72%. On multivariate analysis of all factors, sex (HR 0.77, 95% CI 0.68-0.88, P<0.001), mode of presentation (HR 1.64, 95% CI 1.44-1.87, P<0.01), Dukes' stage (HR 2.69, 95% CI 2.49-2.90, P<0.001), and specialisation (HR 1.24, 95% CI 1.04-1.44, P<0.01) were independently associated with cancer-specific survival. On multivariate analysis of all factors, age (HR 2.46, 2.04-2.97, P<0.001), sex (HR 0.56, 0.45-0.70, P<0.001), and deprivation (HR 1.16, 1.10-1.24, P<0.001) were independently associated with non-cancer-related survival.


CONCLUSIONS
The results of this study confirm that young age does not have a negative impact on cancer-specific survival. Moreover, they show that, with 10-year follow-up, young age does not have a negative impact on non-cancer-related survival.
McMillan
D C
DC
University Department of Surgery, University of Glasgow, Royal Infirmary, Glasgow G31 2ER, UK. d.c.mcmillan@clinmed.gla.ac.uk
McArdle
C S
CS
D000328:Adult; D000367:Age Factors; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis