Are there any differences in colorectal cancer between young and elderly patients?

There is a controversy as to whether colorectal cancer (CRC) in the young population is more aggressive than in the elderly population, and hence has a less favourable prognosis. The aim of this study is to review the results of treatment of young and elderly patients diagnosed with CRC during a 10-year period (1994-2003).

We studied two distinct age groups: young (aged under 40) and elderly (aged over 80), who underwent surgery in the 1st Surgical Department. The young consisted of 11 patients with ages ranging from 37 to 40 (average age 39). The elderly consisted of 45 patients with ages ranging from 81 to 91 (average age 86). We compared clinical signs, pathological grade, Dukes' stage and presence of metastasis, average hospitalisation time, and postoperative mortality.

The results of patients admitted to hospital with a diagnosis of acute abdomen were 9% in the young and 7% of the elderly. Those in stage C in Dukes' classification were 54.5% in the young group, and 44.4% in the elderly group. Those with undifferentiated adenocarcinoma were 36.3% in the young, and 8.8% in the elderly. During surgery, distal metastases were found in 18% of the young and 24.4% of the elderly. The average hospitalisation time of young and elderly patients was 13 and 15.2 days, respectively. The postoperative mortality rates of the young and elderly patients were 0% and 4%, respectively.

Except for a higher rate of undifferentiated adenocarcinoma in young patients, there were no particular differences in the compared factors between the two age groups. The mortality rates do not indicate a less favourable prognosis for the young.