Leff Daniel R, Chen Alvin, Roberts David, Grant Katherine, Western Catherine, Windsor Alastair C J, Cohen C Richard G
Department of Surgical Oncology and Technology, Imperial College, London, UK.
Am Surg. 2007 Jan;73(1):42-7.
Colorectal cancer is the second most common cause of death from cancer in the UK. It is estimated that between 2 to 3 per cent of colorectal cancer occurs in patients younger than the age of 40 years. It remains unclear from the literature whether this group of patients has a worse prognosis from colorectal cancer than the population as a whole. There are no large series that report a 10-year survival in young patients diagnosed with colorectal cancer. The authors' objective was to assess patients diagnosed with colorectal cancer younger than the age of 40 years to determine whether the 5- and 10-year survival rates in a tertiary referral center compares favorably with survival rates obtained at other centers and the population as a whole. A retrospective observational study was conducted and an analysis of the patient's notes was made, specifically looking at age at diagnosis, nature and duration of symptoms, predisposing risk factors for colorectal cancer, the site within the bowel of the colorectal cancer, the type of curative resection performed, Dukes' stage, and details of 5- and 10-year follow-up to assess survival. Forty-nine patients age 40 years or younger received treatment for colorectal cancer at St. Mark's Hospital from 1982 to 1992. The overall 5- and 10-year survival was 58 per cent and 46 per cent respectively. The study provides more evidence to support the fact that young patients with colorectal cancer seem to present with more advanced disease. Despite this, the overall 5-year relative survival rate is comparable if not better than other studies, supporting recent evidence that the prognosis in this group of patients is no worse than for colorectal cancer in the population as a whole.
在英国，结直肠癌是癌症致死的第二大常见病因。据估计，2%至3%的结直肠癌发生在40岁以下的患者中。从文献中尚不清楚这组患者的结直肠癌预后是否比总体人群更差。目前尚无大型系列研究报告年轻结直肠癌患者的10年生存率。作者的目的是评估40岁以下被诊断为结直肠癌的患者，以确定三级转诊中心的5年和10年生存率与其他中心及总体人群的生存率相比是否更优。进行了一项回顾性观察研究，并对患者病历进行了分析，特别关注诊断时的年龄、症状的性质和持续时间、结直肠癌的诱发危险因素、结直肠癌在肠道内的部位、所进行的根治性切除类型、Dukes分期以及5年和10年随访以评估生存情况的细节。1982年至1992年期间，49名40岁及以下的患者在圣马克医院接受了结直肠癌治疗。总体5年和10年生存率分别为58%和46%。该研究提供了更多证据支持以下事实：年轻的结直肠癌患者似乎表现出更晚期的疾病。尽管如此，总体5年相对生存率即便不比其他研究更好也与之相当，这支持了最近的证据，即这组患者的预后并不比总体人群中的结直肠癌患者更差。
