Young Patients (≤35years old) With Colorectal Cancer Have Worse Outcomes Due to More Advanced Disease

被引:78
作者
Fu, Jianfei [1 ,2 ,3 ,4 ]
Yang, Jiao [1 ,2 ,3 ,5 ]
Tan, Yinuo [1 ,2 ,3 ,5 ]
Jiang, Mengjie [1 ,2 ,3 ,5 ]
Wen, Fei [1 ,2 ,3 ]
Huang, Yanqin [1 ,2 ,3 ]
Chen, Hailong [1 ,2 ,3 ]
Yi, Chenghao [1 ,2 ,3 ]
Zheng, Shu [1 ,2 ,3 ]
Yuan, Ying [5 ]
机构
[1] Zhejiang Univ, Sch Med, Chinese Minist Educ, Affiliated Hosp 2,Key Lab Canc Prevent & Intervent, Hangzhou 310009, Zhejiang, Peoples R China
[2] Zhejiang Univ, Sch Med, Key Lab Mol Biol Med Sci, Hangzhou 310009, Zhejiang, Peoples R China
[3] Zhejiang Univ, Sch Med, Affiliated Hosp 2, Inst Canc, Hangzhou 310009, Zhejiang, Peoples R China
[4] Zhejiang Univ, Sch Med, Jinhua Hosp, Dept Oncol,Jinhua Cent Hosp, Jinhua City, Peoples R China
[5] Zhejiang Univ, Sch Med, Affiliated Hosp 2, Dept Med Oncol, Hangzhou 310009, Zhejiang, Peoples R China
基金
国家高技术研究发展计划(863计划);
关键词
SURVIVAL; AGE; CARCINOMA; IMPACT;
D O I
10.1097/MD.0000000000000135
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
An appropriate cutoff of age and the impact of age on colorectal cancer outcomes remain unclear and need to be explored, particularly in China. In total, 2460 colorectal cancer patients were studied retrospectively. All patients were divided into 6 groups according to their ages at the time of diagnosis: <= 30, 31 to 35, 36 to 40, 41 to 45, 46 to 50, and >= 50 years. A suitable cutoff age for defining young adult colorectal cancer was explored according to the distribution of survival in each group. Clinical characteristics and prognosis between the young adult group and the older group were then compared. According to the survival curves for each group, 35 years old was considered a suitable cutoff age for defining young adult colorectal cancer. There were 140 (5.7%) and 2320 (94.3%) cases in the young adult and older groups, respectively. The proportion of stage III-IV tumors was significantly higher in the young adult group (69.3%) than in the older group (46.4%) (P = 0.000). The univariate analysis showed that the 5-year overall survival (OS) rate and the 10-year OS rate in the young adult group were 48.9% and 38.6%, respectively, whereas in the older group, they were 63.6% and 56.9%, respectively. The young adult group had a worse prognosis (P = 0.000). The multivariate analysis showed that age was not an independent prognostic factor (relative risk 0.787, P = 0.062). After adjusting for tumor stage, the hazard proportion of death in the young adult group increased by 27.6%, but this difference was not significant (P = 0.053). Stratified analyses showed that the young adults with stage IV tumors had a worse survival rate (P = 0.046). Patients <= 35 years who were diagnosed with colorectal cancer had a worse prognosis because of a higher proportion of advanced stage tumors. When stage-to-stage analysis was performed, it was found that young adult colorectal cancer patients had a worse outcome only if they had stage IV tumors.
引用
收藏
页数:7
相关论文
共 26 条
[1]
Presentation and outcomes of patients aged 30 years and younger with colorectal cancer: a 20-year retrospective review [J].
Al-Barrak, Jasem ;
Gill, Sharlene .
MEDICAL ONCOLOGY, 2011, 28 (04) :1058-1061
[2]
Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and long-term: Analysis of survival and prognostic markers [J].
Chan, K. K. ;
Dassanayake, B. ;
Deen, R. ;
Wickramarachchi, R. E. ;
Kumarage, S. K. ;
Samita, S. ;
Deen, K. I. .
WORLD JOURNAL OF SURGICAL ONCOLOGY, 2010, 8
[3]
Chung YFA, 1998, BRIT J SURG, V85, P1255
[4]
Young-onset colorectal cancer in patients with no known genetic predisposition - Can we increase early recognition and improve outcome? [J].
Dozois, Eric J. ;
Boardman, Lisa A. ;
Suwanthanma, Weerapat ;
Limburg, Paul J. ;
Cima, Robert R. ;
Bakken, Julie L. ;
Vierkant, Robert A. ;
Aakre, Jeremiah A. ;
Larson, David W. .
MEDICINE, 2008, 87 (05) :259-263
[5]
Annual Report to the Nation on the Status of Cancer, 1975-2006, Featuring Colorectal Cancer Trends and Impact of Interventions (Risk Factors, Screening, and Treatment) to Reduce Future Rates [J].
Edwards, Brenda K. ;
Ward, Elizabeth ;
Kohler, Betsy A. ;
Eheman, Christie ;
Zauber, Ann G. ;
Anderson, Robert N. ;
Jemal, Ahmedin ;
Schymura, Maria J. ;
Lansdorp-Vogelaar, Iris ;
Seeff, Laura C. ;
van Ballegooijen, Marjolein ;
Goede, S. Luuk ;
Ries, Lynn A. G. .
CANCER, 2010, 116 (03) :544-573
[6]
Gilliland FD, 1997, CANCER-AM CANCER SOC, V79, P564, DOI 10.1002/(SICI)1097-0142(19970201)79:3<564::AID-CNCR20>3.0.CO
[7]
2-0
[8]
Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study [J].
Gray, Richard ;
Barnwell, Jennifer ;
McConkey, Christopher ;
Hills, Robert K. ;
Williams, Norman S. ;
Kerr, David J. .
LANCET, 2007, 370 (9604) :2020-2029
[9]
Adolescent and Young Adult Colorectal Cancer [J].
Hubbard, Joleen M. ;
Grothey, Axel .
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK, 2013, 11 (10) :1219-1225
[10]
LARGE-BOWEL CANCER IN THE YOUNG - A NATIONAL SURVIVAL STUDY [J].
ISBISTER, WH ;
FRASER, J .
DISEASES OF THE COLON & RECTUM, 1990, 33 (05) :363-366