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Colorectal cancer in young patients
P Barillari1, G Ramacciato, S Valabrega
1First Department of Surgery, University of Rome La Sapienza, Italy.
Insights
Colorectal cancer is rare in young adults. This study found no significant differences in prognosis or five-year survival rates between young and older patients with colorectal cancer.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Colorectal cancer (CRC) is uncommon in individuals under 40.
- Early-onset CRC presents unique challenges in diagnosis and management.
- Understanding CRC in younger populations is crucial for tailored treatment strategies.
Purpose of the Study:
- To determine the incidence of colorectal cancer in patients under 40 years of age.
- To compare the clinical characteristics, treatment outcomes, and survival rates of young CRC patients with older counterparts.
- To evaluate the prognostic factors influencing CRC in different age groups.
Main Methods:
- Retrospective review of 571 colorectal cancer patients treated between 1978 and 1984.
- Categorization into a young group (≤39 years, n=44) and a control group (≥40 years, n=527).
- Analysis of tumor location, stage, operability, operative mortality, complications, and five-year survival rates.
Main Results:
- Tumor distribution showed variations between young and older groups, with left colon involvement more frequent in the young.
- Operability and operative mortality rates were comparable, with 0% mortality in the young group.
- Five-year survival rates were similar: 56.7% for young patients versus 52.1% for older patients.
Conclusions:
- Colorectal cancer in patients under 40 does not appear to confer a worse prognosis compared to older individuals.
- Age is not a significant prognostic factor for colorectal cancer survival.
- Further research into the specific biology and risk factors of early-onset CRC is warranted.
Abstract:
Colorectal cancer is rare in patients under 40 years of age. We reviewed all colorectal cancer patients treated at the First Department of Surgery of the University of Rome, to determine the true incidence of large bowel cancer in young patients. During the period 1978-1984 a total of 571 patients were indexed. Out of these 44 were 39 years of age or less. A group of 527 patients 40 years of age or over served as a control. Neoplasms were localized in the right colon in 19 cases and in the left colon in 25 patients, in the young group. In the control group 178 patients presented neoplasms localized in the right colon, while 349 presented tumors localized in the left colon. According to tumor advancement in the young group tumor classification from A stage tumor through D stage was: 4, 6, 14, 5, 9, 6. In the control group 22 patients presented A stage tumors, 106 B1, 139 B2, 50 C1, 118 C2, 92 D tumors. The operability rate was 93.2% in the young group, and 92% in the old one. The operative mortality rate was 0% in the young group, and 2.5% in the old one. Four complications occurred in the young patients, and 57 in the old patients. The five years survival rate was 56.7% and 52.1% in young and old patients respectively. The results of our study indicate that there are no significant differences in prognosis and five years survival in young patients with colorectal cancer.