Comparable survival for young rectal cancer patients, despite unfavourable morphology and more advanced-stage disease

Orsini, R.G.; Verhoeven, Rob H.A.; Lemmens, Valery; Steenbergen, L.N. van; Hingh, Ignace H. J. T. de; Nieuwenhuijzen, Grard A. P.; Rutten, H.J.T.

doi:10.1016/j.ejca.2015.06.005

Cited by 30 publications

(32 citation statements)

References 30 publications

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“…In our study, colorectal cancer in young adults was observed in 26% of the patients, which is quite high compared to the rate observed in Europe (3%) and the United states (20%). 11,12 However, the proportion of colorectal cancer in young patients observed in our study is comparable to that observed in India and other Asian countries where it ranges from 30 to as high as 43.8%. 12,13 A 10 year review from our institute (1999-2008) revealed a total of 234 patients with colorectal cancer.…”

Section: Discussionsupporting

confidence: 80%

“…14 Young patients have been observed to present colorectal cancer in more advanced stage, with poor morphology and poor prognosis. 11 In our study, 56% of patients in the younger age group had stage III disease compared to 34% in the older age group. Stage II disease, on the other hand, was almost equally common in the two groups, 40% and 44%, respectively.…”

Section: Discussionmentioning

confidence: 46%

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Comparison of Stage and Lymph Node Ratio in Young and Older Patients with Colorectal Cancer Operated in a Tertiary Hospital in Nepal

Ghimire

Singh

Kurlberg

et al. 2018

J Nepal Health Res Council

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Background: Colorectal cancer is being diagnosed more frequently in the young and it presents in an advanced stage. In TNM staging, stage depends on tumor size and number of positive nodes, which depend on location of tumor as well as the extent of dissection.The lymph node ratio is regarded as a more reliable marker for prognosis. In this study, we compare epidemiology of colorectal cancer in the young (<40 years) and older patients as well as the LNR. Methods:Patients with colorectal cancer operated at the Tribhuvan University Teaching Hospital, Kathmandu, Nepal for a period of 4 years (2012 -2016) were included in the study. Patients were grouped into young (≤ 40 years) and older (> 40 years) and clinic-pathological data such as site of lesion, clinical stage, and lymph node ratio were compared. Results:Of the 95 patients of colorectal cancer, 25 patients were of age ≤ 40 years (26%) and they had a higher median stage at diagnosis. In patients above 40 years, it was diagnosed at a relatively earlier stage. The mean number of positive nodes was 11.64 in younger patients whereas it was 18.34in those more than 40 years of age,but younger patients had higher lymph node ratio than elderly (0.31 vs 0.13) (P-value ≤ 0.005). Conclusions:Young patients with colorectal cancer tend to have more advanced disease. The lymph node metastasis and lymph node ratio tend to be higher in young patients.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 46%

Comparison of Stage and Lymph Node Ratio in Young and Older Patients with Colorectal Cancer Operated in a Tertiary Hospital in Nepal

Ghimire

Singh

Kurlberg

et al. 2018

J Nepal Health Res Council

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“…Some authors have suggested that the worse survival observed in young patients with CRC could be attributed to delayed diagnosis and late presentation with advanced disease, whereas others believe it is due to young adults presenting with more histologically aggressive disease [33]. Other studies suggest that although young patients were more likely to have advanced disease and unfavourable histopathological features, their prognosis was similar to or better than the older group [12,20,27,29,31,35]. This is because younger patients have better performance status and are therefore more likely to tolerate more aggressive treatment (surgery and chemotherapy).…”

Section: Discussionmentioning

confidence: 99%

The association of age with the clinicopathological characteristics and prognosis of colorectal cancer: a UK single‐centre retrospective study

Anele

Askari

Navaratne³

et al. 2019

Colorectal Disease

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Introduction Colorectal cancer (CRC) is uncommon in patients under the age of 40 years and its association with poor histological features and survival is uncertain. This study aimed to evaluate age‐related differences in clinicopathological features and prognosis in patients diagnosed with CRC. Method A single‐centre retrospective review of all patients diagnosed with CRC between 2004 and 2013 was performed. Patients were stratified into three age groups: (1) 18–40 years, (2) 41–60 years and (3)> 60 years. Clinicopathological characteristics and outcomes were compared between the three groups. Results A total of 1328 patients were included, of whom 57.2% were men. There were 28 (2.1%) patients in group 1, 287 (21.6%) in group 2 and 1013 (76.3%) in group 3. 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. Group 1 had significantly worse disease‐free survival (DFS) than the two older groups (44%, 78% and 77%, respectively; P = 0.022). Multivariate analysis demonstrated that age was not an independent prognostic factor whereas Stage III disease [hazard ratio (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. Conclusion Patients under the age of 40 are more likely to present with rectal cancer and have comparable histological features than the older groups. Despite higher rates of adjuvant and neoadjuvant treatment, the young group were found to have worse DFS.

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“…(8) Иако друга истраживања указују да код младих особа (мање од 40 година), карцином ректума има неповољнију морфологију тумора у односу на пацијенте старије групе стопе преживљавања су подједнаке, тако да је младост важан про гностички фактор. (15) Код примарног карцинома ректума аде но карцином је најчешћи хистолошки тип тумора, али није доказан као прогно сти чки фактор. (12) У нашем раду од укупног броја оперисаних аденокарцином је дијагно стикован код 96% оболелих тако да се до би јени резултати углавном слажу са резу лтатима доступне литературе.…”

Section: дискусијаunclassified

“…(12) У нашем раду од укупног броја оперисаних аденокарцином је дијагно стикован код 96% оболелих тако да се до би јени резултати углавном слажу са резу лтатима доступне литературе. (10,15) Степен диферентованости тумора ре ктума је значајан прогностички фактор, како показују и неке студије. (16,17) У на шем истраживању карцином ректума је угла вном дијагностикован као средње ди фе рентован тумор (91,8%), док су остали хистолошки градуси тумора били проце нтуално подједнако заступљени.…”

Section: дискусијаunclassified

Recurrent rectal cancer related to patients sex

Dožić¹,

Stojanović-Rundić²,

Plesinac-Karapandzic³

et al. 2016

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Comparable survival for young rectal cancer patients, despite unfavourable morphology and more advanced-stage disease

Cited by 30 publications

References 30 publications

Comparison of Stage and Lymph Node Ratio in Young and Older Patients with Colorectal Cancer Operated in a Tertiary Hospital in Nepal

Comparison of Stage and Lymph Node Ratio in Young and Older Patients with Colorectal Cancer Operated in a Tertiary Hospital in Nepal

The association of age with the clinicopathological characteristics and prognosis of colorectal cancer: a UK single‐centre retrospective study

Recurrent rectal cancer related to patients sex

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