The association of age with the clinicopathological characteristics and prognosis of colorectal cancer: a UK single‐centre retrospective study

Abstract

Introduction Colorectal cancer (CRC) is uncommon in patients under the age of 40 years and its association with poor histological features and survival is uncertain. This study aimed to evaluate age‐related differences in clinicopathological features and prognosis in patients diagnosed with CRC. Method A single‐centre retrospective review of all patients diagnosed with CRC between 2004 and 2013 was performed. Patients were stratified into three age groups: (1) 18–40 years, (2) 41–60 years and (3)> 60 years. Clinicopathological characteristics and outcomes were compared between the three groups. Results A total of 1328 patients were included, of whom 57.2% were men. There were 28 (2.1%) patients in group 1, 287 (21.6%) in group 2 and 1013 (76.3%) in group 3. Group 1 had the highest proportion of rectal tumours (57.1% in group 1, 50.2% in group 2 and 31.9% in group 3; P < 0.001). Tumour histology and disease stage were comparable between the groups. Group 1 had significantly worse disease‐free survival (DFS) than the two older groups (44%, 78% and 77%, respectively; P = 0.022). Multivariate analysis demonstrated that age was not an independent prognostic factor whereas Stage III disease [hazard ratio (HR) 4.42; 95% CI 2.81–6.94; P < 0.001] and neoadjuvant chemotherapy (HR 1.65; 95% CI 1.06–2.58; P = 0.026) were associated with increased risk of recurrence. Conclusion Patients under the age of 40 are more likely to present with rectal cancer and have comparable histological features than the older groups. Despite higher rates of adjuvant and neoadjuvant treatment, the young group were found to have worse DFS.

A Novel Risk Classification Model Predicts Overall Survival and Locoregional Surgery Benefit in Colorectal Patients with Distant Metastasis at the Initial Diagnosis

“…In views of epidemiology, age has been widely accepted as a major risk factor for sporadic CRC (14). This is consistent with our ndings in the study.…”

WITHDRAWN: Prognostic Nomograms based on Homogeneous and Heterogeneous Associated Factors for Predicting the Overall Survival of Colorectal Cancer Patients with Distant Metastases

“…Previous studies have mostly focused on the prognosis of CRC patients, and whether age is an independent factor remains controversial. Some studies reported that young patients with CRC had a worse prognosis than older patients [22][23][24]. Some studies reported the opposite results [25,26], and another study demonstrated that age was not associated with the prognosis of CRC [27].…”

Characteristics and outcomes of colorectal cancer surgery by age in a tertiary center in Korea: a retrospective review

“…Even when considering that our study included only patients who underwent surgery, the larger proportion of younger patients compared to other countries remains valid. According to a study conducted in the United Kingdom [ 12 ], about 2.1% of CRC patients are less than 40 years old. In contrast, in Korea, the proportion of CRC patients under 40 years of age is reported to be 6.5% [ 4 ].…”

“…However, the 5-year survival rates of CRC patients have been found to differ in different age groups [7][8][9][10][11]. According to Anele et al [12], patients over the age of 60 years had lower survival rates compared to younger patients in even same stage. It is still unclear whether it was due to differences in tumor biology or because relatively passive treatments were selected for elderly patients.…”