Clinicopathological Features of Colorectal Cancer at the Extremes of Age

Abstract

Objective: To determine the clinicopathological features of patients with colorectal cancer (CRC) at the extremes of age and compare differences across the younger and older age groups.Method: Data was obtained from the CRC Registry for patients diagnosed during the 4-year period commencing January 1, 2011. Variables analyzed included clinical presentation, tumour site, stage, various histopathologic features and adequacy of nodal resection. Results:Of 900 cases entered into our database, 59 were age 40 and under and 119 were age 80 and over (7% and 13% respectively). These patients were referenced with patients diagnosed between age 50-70 years and they formed the basis of this study. Common clinical presentations across both groups were bleeding per rectum (26% vs 17%), change in bowel habits (both 31%) and abdominal pain (16% vs 14), with no statistical difference between groups (P = 0.556). Most tumours occurred in the rectum (27%) and the sigmoid colon (26%) with 72% of all tumours being moderately differentiated. Comparison across age groups revealed equivalent tumour distribution. However, younger patients had more signet ring histology (15% vs 4%; P = 0.035) while there was a trend towards older patients having perineural invasion (15% vs 7%; P = 0.088). All categories of patients had similar tumour (T) stage while significantly more nodes were examined for younger patients (P = 0.002). The number of positive nodes did not differ between the two extremes (P = 0.500). Conclusions:This review demonstrates that while there are a few measurable differences in CRC in patients at the extremes of age, most patients were overall similar in their clinical symptoms, tumour distribution and stage at diagnosis.