Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan.
Am J Surg. 2011 Nov;202(5):574-82. doi: 10.1016/j.amjsurg.2010.10.014. Epub 2011 Aug 26.
The prognosis of patients with colorectal cancer (CRC) of different onset ages is controversial.
Data were obtained from a prospective database at Taipei Veterans General Hospital. There were 2,738 newly diagnosed patients with CRC from 2001 to 2006. Two extreme age groups, younger (≤40 years) and elderly (≥80 years), were analyzed to compare clinicopathologic characteristics and prognosis after exclusion of specific cancer syndrome.
A total of 322 patients were enrolled in this prospective study. The younger group consisted of 69 patients with mean age of 33.5 years, and the elderly group consisted of 253 patients with mean age of 83.4 years. Younger patients had a higher incidence of mucinous cell type (14.5% vs 6.3%, P = .05), poorly differentiated adenocarcinoma (26.1% vs 6.3%, P < .001), more advanced disease (82.6% vs 41.9%, P < .001), poorer disease-free survival (67.2% vs 79.3%, P = .048), and cancer-specific survival (44.1% vs 73.1%, P < .001) than elderly patients.
In patients with CRC of younger onset, without relevant predisposing risk factors, younger patients have more advanced stages of disease, more aggressive histopathologic characteristics, and poorer prognoses compared with older patients.
不同发病年龄的结直肠癌（CRC）患者的预后存在争议。
数据来自于台北荣民总医院的一个前瞻性数据库。共有 2001 年至 2006 年间 2738 例新诊断的 CRC 患者。排除特定癌症综合征后，分析了两个极端年龄组（≤40 岁和≥80 岁）的临床病理特征和预后。
共有 322 例患者纳入本前瞻性研究。年轻组有 69 例患者，平均年龄为 33.5 岁，老年组有 253 例患者，平均年龄为 83.4 岁。年轻患者黏液细胞型（14.5%比 6.3%，P =.05）、低分化腺癌（26.1%比 6.3%，P <.001）、更晚期疾病（82.6%比 41.9%，P <.001）、无病生存率（67.2%比 79.3%，P =.048）和癌症特异性生存率（44.1%比 73.1%，P <.001）均低于老年患者。
在发病年龄较轻且无相关易患风险因素的 CRC 患者中，与老年患者相比，年轻患者的疾病分期更晚，组织病理学特征更具侵袭性，预后更差。
