Prognostic factors and survival of patients aged less than 45 years with colorectal cancer

Abstract

Colorectal cancers in 92 patients aged 45 years and under presenting over a 20-year period (1970-1990) were studied. A delay of more than 4 months in presentation was seen in 27 per cent of patients. All underwent surgery, 14 per cent emergency and 86 per cent elective, and follow-up was available for 91 patients. Overall, 14 per cent of patients had Dukes A tumours, 32 per cent Dukes B, 36 per cent Dukes C and 18 per cent Dukes 'D'. Local recurrence occurred in eight (9 per cent) of the 92 patients and overall 5- and 10-year survival rates were 61 and 59 per cent. Multivariate analysis identified independent risk factors for local recurrence to be mucinous carcinoma (relative effect 4.9) and the presence of intramural vascular invasion by tumour (relative effect 9.4). For overall survival, independent risk factors were involvement of the regional lymph nodes by tumour (relative effect 2.0), extramural invasion by tumour cells (relative effect 3.0), tumour size (relative effect 1.8) and the presence of metastatic disease at initial diagnosis (relative effect 3.7).

Liver metastasis in gastric cancer with particular reference to lymphatic advancement

“…Maehara et al [7,8] reported that they had found the concomitant presence of lymph node metastasis with liver metastasis, and they suggested that sm, Invasion to submucosa; mp, invasion to muscularis propria; ss, invasion to subserosa; se~, invasion to serosa or exposed and adjacent lymphatic advancement was related to liver metastasis, and that vascular invasion was an independent risk factor for liver metastasis of gastric cancer. Other reported findings in regard to liver metastasis have shown that the risk factor with the greatest significance was lymph node metastasis [5,6] and that the proportion of liver metastasis increased with an increased degree of lymph node metastasis. Also, liver metastasis accounted for 50% of the recurrences in early gastric carcinoma [13].…”

“…However, liver metastasis of gastric cancer without venous invasion has been recognized. Some investigators have reported no relationship between liver metastasis and venous invasion [5,6]. It has been reported that lymphatic involvement is closely linked with liver metastasis [7,8].…”

Evidence for an age‐related influence of microsatellite instability on colorectal cancer survival

“…[1][2][3][4][5][6]33,34 Patients presenting before age 30 years tended to have more advanced malignancy (Dukes' stage C or D, 64% vs. 51%) and a greater proportion of mucinous-type tumours (37% vs. 23%), which is consistent with previous smaller studies. [35][36][37][38][39][40] Although there is evidence that mucinous tumours are more likely to recur locally, there is no convincing evidence for an effect on ultimate survival. 3,38,39,41 This concurs with our findings, since Cox proportional analysis did not detect an independent effect of histologic type on survival.…”

“…[35][36][37][38][39][40] Although there is evidence that mucinous tumours are more likely to recur locally, there is no convincing evidence for an effect on ultimate survival. 3,38,39,41 This concurs with our findings, since Cox proportional analysis did not detect an independent effect of histologic type on survival.…”

Mucinous carcinoma of the rectum: a distinct clinicopathological entity

“…There is a higher incidence in younger patients [13][14][15]. A study by Dozois et al [16], which investigated the characteristics of colon and rectal cancer in patients below the age of 50, found that patients with mucinous tumours had a mean age at presentation of 42.2 years.…”