Younger patients with colorectal cancer (CRC) have poorer disease-free survival (DFS) but not overall survival (OS), according to the findings of a study published in the journal Colorectal Disease.
The single-centre retrospective review included all patients diagnosed with CRC at a single UK centre between 2004 and 2013. Patients were stratified into three age groups: (1) 18-40 years, (2) 41-60 years and (3) >60 years.
Overall, 1328 patients were included: 28 (2.1%) patients in group 1; 287 (21.6%) in group 2; and 1013 (76.3%) in group 3. Initially 56 patients were diagnosed with CRC at the age ≤40, accounting for 3.8% of the overall number. However, 28 patients in this group were found to have CRC predisposing conditions and were excluded.
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.
Although not statistically significant, the results show that 67% of 18-40 year olds presented with advanced disease and had a higher rate of poorly differentiated adenocarcinoma and mucinous tumours compared with the other two groups.
Group 1 had significantly worse DFS compared with the older two groups. In the younger age group, five-year cumulative DFS was 44%, compared with 78% in group 2 and 77% in group 3 (P=0.022).
Although group 1 had the poorest DFS, multivariate analysis demonstrated that age was not an independent prognostic factor. Stage 3 disease (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.
