Clinical characteristics and prognosis of young patients with colorectal cancer in Eastern China

Abstract

Compared with older patients, the younger patients have lower survival, especially in the subgroups of stage III and IV disease and radical surgery.

Clinico-Pathological Patterns and Survival Outcome of Colorectal Cancer in Young Patients: Western Saudi Arabia Experience

“…Furthermore, in Saudi patients diagnosed from 1994 to 2004, the five-year OS was 63.3% for patients with localized disease, 50.2% for those with regional disease, and 14.7% for patients with metastases (Al-Ahwal et al, 2013). Similarly, in a Chinese study, patients younger than 30 years tend to present with advanced stages and they had worse survival than older patients (5-and 10-year OS were 33.9% and 26.1%, respectively in the younger group compared to 60.1% and 52.2%, respectively in the older group) (Fu et al, 2013).…”

The impact of young age on the prognosis for colorectal cancer: a population-based study in Taiwan

“…Older CRC patients (>70 years old) who tend to have well-differentiated, right-sided tumors, typically have a higher rate of non-cancer-related deaths compared to younger patients (31), while younger patients had significantly lower rates of OS possibly because they are diagnosed at a late stage, and have poorly differentiated, more aggressive tumors (32,33). Consistent with this, CRC patients aged 20-40 years old have been shown to have a higher incidence of mucinous, and signet cell tumors, and a higher percentage of poorly differentiated and anaplastic tumors compared to patients aged 60-80 (8,12,18,26,34).…”

Colorectal cancer in the young, many questions, few answers

“…These are (1) proximally located mucinous adenocarcinomas which are commonly well circumscribed and are moderate-to-well differentiated; (2) proximally located poorly differentiated adenocarcinomas which show failure of gland formation with malignant epithelium arranged in small clusters, irregular trabeculae or large aggregates in well circumscribed tumours; and (3) adenomas in HNPCC indicating features of high cancer risk including villous and high grade intraepithelial neoplasia which display good circumscription and present as polypoid growths, plaques, bulky masses or ulcers rather than diffuse growths or strictures [40] . In a single centre study, mucinous and signet-ring histological subtypes and poor to non-differentiated tumours were frequently seen among the young [38,41,42] , and accounted for 41.5% of all tumours [38] . The incidence of tumour in situ (Tis) was lower in young patients compared with older patients and may indicate either failure of early detection or rapid progression from adenoma to carcinoma in the young compared with older patients [43] .…”

“…The incidence of tumour in situ (Tis) was lower in young patients compared with older patients and may indicate either failure of early detection or rapid progression from adenoma to carcinoma in the young compared with older patients [43] . Other features that suggest more aggressive tumour biology in the young compared with older patients are the higher percentages of patients with lymph node metastasis (≥ 4 lymph nodes), distance metastasis and stage Ⅳ disease [41,42] .…”