Colorectal carcinoma in young adults

Okuno, Masahiro; Ikehara, Teruyuki; Nagayama, Masayoshi; Sakamoto, Kazutsugu; Kato, Yasuyuki; Umeyama, Kazuhiro

doi:10.1016/0002-9610(89)90606-5

Cited by 51 publications

(44 citation statements)

References 9 publications

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“…12 Some series find a similar rate of family history in young and old patients with colorectal cancer. 7,9,18 Different molecular biologic features of the tumor, with higher frequency of acquired 9 or inherited microsatellite instability, as in HNPCC, 23 in the young have been described.…”

Section: Discussionmentioning

confidence: 97%

“…Several previous studies on colorectal cancer have demonstrated poor prognosis in the young patients, [17][18][19][20][21] although few studies report the influence of age on clinicopathologic features and prognosis among the entire range of younger than average-aged patients with rectal cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Although the upper age limit of these patients remains undefined, most studies have classified patients younger than aged 40 years as young. Some studies have revealed a more advanced tumor stage at the time of diagnosis, 5-8 more aggressive histopathologic characteristics, [9][10][11][12][13][14][15][16] and inferior rate of survival [17][18][19][20][21] in younger compared with older patients. Other studies contradict these findings.…”

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confidence: 99%

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Rectal Cancer in the Young Patient

Endreseth

Romundstad²,

Myrvold

et al. 2006

Diseases of the Colon &Amp; Rectum

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Rectal Cancer in the Young Patient

Endreseth

Romundstad²,

Myrvold

et al. 2006

Diseases of the Colon &Amp; Rectum

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“…[1][2][3][4][5][6]33,34 Patients presenting before age 30 years tended to have more advanced malignancy (Dukes' stage C or D, 64% vs. 51%) and a greater proportion of mucinous-type tumours (37% vs. 23%), which is consistent with previous smaller studies. [35][36][37][38][39][40] Although there is evidence that mucinous tumours are more likely to recur locally, there is no convincing evidence for an effect on ultimate survival. 3,38,39,41 This concurs with our findings, since Cox proportional analysis did not detect an independent effect of histologic type on survival.…”

Section: Discussionmentioning

confidence: 99%

Evidence for an age‐related influence of microsatellite instability on colorectal cancer survival

Farrington

McKinley

Carothers

et al. 2002

Intl Journal of Cancer

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It is well established that microsatellite instability (MSI), the hallmark of defective DNA mismatch repair (MMR), is associated with prolonged survival in colorectal cancer compared with tumours that are microsatellite stable (MSS). MSI in sporadic colorectal tumours is primarily due to epigenetic silencing of MLH1. However, there are no prospective population-based studies of survival in patients with germline MMR gene mutations who develop cancer. Although MSI is almost universal in tumours from HNPCC family members, there is a potential confounding effect of ascertainment and other biases that could explain the apparent survival benefit in HNPCC families. Resolving whether germline MMR gene mutations impact on survival is important because it potentially undermines the rationale for surveillance of mutation carriers. Here, we report an investigation of the influence of MSI on survival in cohorts of cancer patients (aged < 30 years at diagnosis, n ‫؍‬ 118; non-age-selected, n ‫؍‬ 181) in the context of clinicopathologic variables. There was a substantial age-related influence of tumour MSI status on survival. In young patients with tumour MSI, 65% of patients with MSI tumours had germline MSH2 or MLH1 mutations. Clinicopathologic variables and tumour MSI of the cohort were studied with respect to survival and compared with control groups. Young patients had excess MSI tumours (p < 0.000001), mucinous tumours (p < 0.01), advanced disease (p ϳ 0.001) and poorer 5-year survival compared with older cases. Cox proportional hazard analysis identified Dukes' stage, age at diagnosis and calendar year of treatment as independent predictors of survival. There was no detectable association between tumour MSI and survival in young patients, although we confirmed previous observations that MSI is associated with better prognosis in later onset cohorts. These findings underscore the rationale for surveillance and early identification of tumours in MMR gene carriers as well as refining understanding of the influence of MSI on cancer progression.

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“…However, while some studies reported that younger patients had a more advanced stage of disease at the time of diagnosis (4,(12)(13)(14)(15), more aggressive histopathologic characteristics (16)(17)(18)(19)(20), and poorer prognosis compared to older patients (10,(21)(22)(23), data from other studies contradicted these findings (24)(25)(26)(27)(28). Interestingly, it was recently reported that the poor prognosis of patients <35 years old was primarily due to their advanced stage tumors; however, after excluding the impact of tumor stage, age was not an independent prognostic factor (29).These conflicting data could be due to factors such as heterogeneity between the different studies in terms of patient numbers, percentage of patients undergoing curative resection, percentage of patients receiving neoadjuvant therapy, and failure to adjust for potential confounding factors.…”

Section: Introductionmentioning

confidence: 99%

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

Chou

Tseng

Shiue

2017

Japanese Journal of Clinical Oncology

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Background: The impact of age as a prognostic factor for patients with colorectal cancer (CRC) remains controversial, possibly due to heterogeneity between studies in terms of patient numbers, percentage of patients undergoing curative resection, percentage of patients receiving neoadjuvant therapy, or failure to adjust for potential confounding factors. This study used colorectal cancer survival data from the Taiwan Cancer Registry database in order to comprehensively analyze age as a prognostic factor. Methods: Survival data were analyzed for 62 060 CRC patients diagnosed with adenocarcinoma, mucinous adenocarcinoma, or signet-ring cell carcinoma of the colon and rectum between 1998 and 2005. The rates of all-cause mortality and CRC-related mortality were determined using Kaplan-Meier analysis, and the log-rank test was used to compare differences in survival between different age groups. The crude and adjusted hazard ratios for all-cause and CRC-related mortalities were calculated according to the estimates from the univariable and multivariable Cox proportional hazard models. Results: Patients in the ≤40 and the 41-50 age groups had a higher proportion of mucinous adenocarcinoma (P < 0.001) and signet-ring cell carcinoma (P < 0.001) compared to the older age groups. After adjusting for gender, histology, and tumor site, patients in the ≤40 age group had a poorer overall survival (OS) and cancer-specific survival compared to patients in the 41-50 and 51-60, and 61-70 age groups (P < 0.001), but a better OS and cancer-specific survival compared to patients in the 71-80 and >80 age groups (P < 0.001). Conclusions: Our study indicated that age is an important consideration while determining the clinical management of CRC patients.

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Colorectal carcinoma in young adults

Cited by 51 publications

References 9 publications

Rectal Cancer in the Young Patient

Rectal Cancer in the Young Patient

Evidence for an age‐related influence of microsatellite instability on colorectal cancer survival

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

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