Ciarrocchi Andrea, Amicucci Gianfranco
General and Emergency Surgery, Department of Surgery, University of L'Aquila, 67100, L'Aquila, Italy.
J Gastrointest Cancer. 2013 Sep;44(3):264-9. doi: 10.1007/s12029-013-9507-5.
Colon carcinoma is rare in patients under 40 years but incidence is increasing. Results regarding outcome of this age group have been controversial and difficult to interpret. Some authors have reported a worse prognosis related to advanced stage at diagnosis and cancer-aggressive behavior. We tried to assess whether sporadic colon carcinoma in young patients is a distinct disease with different etiology and how this reflects on outcome.
Most relevant papers published and indexed on PubMed in the last 20 years were reviewed. Epidemiological data were retrieved from the Surveillance, Epidemiology and End Results database and discussed.
Stage-specific analyses adjusted for age have demonstrated that prognosis is related to tumor stage regardless of age. Advanced stage is partly due to tumor biology and to delayed diagnosis. Younger patients show a better performance status that allows aggressive multimodal treatment.
Colon carcinoma in young adults appears to be a distinct disease characterized by biological aggressiveness, but prognosis is not worse due to a better performance status at time of surgical intervention.
结肠癌在40岁以下患者中较为罕见，但发病率正在上升。关于该年龄组患者预后的结果一直存在争议且难以解读。一些作者报告称，诊断时处于晚期以及癌症侵袭性与预后较差有关。我们试图评估年轻患者的散发性结肠癌是否是一种具有不同病因的独特疾病，以及这如何反映在预后上。
回顾了过去20年在PubMed上发表并被索引的最相关论文。从监测、流行病学和最终结果数据库中检索并讨论了流行病学数据。
针对年龄进行调整的特定阶段分析表明，无论年龄如何，预后均与肿瘤分期有关。晚期部分归因于肿瘤生物学特性和诊断延迟。年轻患者表现出较好的身体状况，这使得他们能够接受积极的多模式治疗。
年轻成年人的结肠癌似乎是一种以生物学侵袭性为特征的独特疾病，但由于手术干预时身体状况较好，预后并不更差。
