Zhao Liying, Bao Feng, Yan Jun, Liu Hao, Li Tingting, Chen Hao, Li Guoxin
Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, People's Republic of China.
Department of General Surgery, Mianyang Central Hospital, Mianyang, People's Republic of China.
Int J Colorectal Dis. 2017 Aug;32(8):1147-1156. doi: 10.1007/s00384-017-2809-5. Epub 2017 Apr 7.
The present study aimed to explore the survival outcomes of patients with colorectal cancer (CRC) aged 35 years and younger.
This retrospective cohort study included a total of 995 patients with CRC treated between January 2003 and September 2011. The patients were assorted into the young (aged 18-35 years) and older (aged 36-75 years) groups. The clinical characteristics and survival outcomes of the patients in the young group were compared with those of the patients in the older group for evaluation.
Compared with the older group, a significantly higher number of patients in the young group had right-sided colon cancer (30.9 vs. 19.6%, P = 0.026), high histologic grade tumor (14.7 vs. 6.4%, P = 0.021), and stage III disease (50.0 vs. 35.5%, P = 0.016). In stage III disease, compared with the older group, the patients in the young group had worse survival outcome in terms of 5-year overall survival (OS, P = 0.007), cancer-specific survival (CSS, P = 0.010), and disease-free survival (DFS, P = 0.039). Multivariate analysis revealed that age ≤35 years was an independent risk factor in terms of 5-year OS (hazard ratio [HR] = 1.68; 95% confidence interval [CI]: 1.12-2.54; P = 0.012), CSS (HR = 1.74; 95% CI: 1.15-2.65; P = 0.009), and DFS (HR = 1.58; 95% CI: 1.06-2.35; P = 0.024).
The young patients with CRC aged 35 years and younger had worse prognosis compared with older patients, especially for stage III disease.
本研究旨在探讨35岁及以下的结直肠癌（CRC）患者的生存结局。
这项回顾性队列研究共纳入了2003年1月至2011年9月期间接受治疗的995例CRC患者。这些患者被分为年轻组（18 - 35岁）和老年组（36 - 75岁）。比较年轻组患者与老年组患者的临床特征和生存结局以进行评估。
与老年组相比，年轻组中右侧结肠癌患者的比例显著更高（30.9%对19.6%，P = 0.026），组织学高级别肿瘤患者的比例更高（14.7%对6.4%，P = 0.021），以及III期疾病患者的比例更高（50.0%对35.5%，P = 0.016）。在III期疾病中，与老年组相比，年轻组患者在5年总生存（OS，P = 0.007）、癌症特异性生存（CSS，P = 0.010）和无病生存（DFS，P = 0.039）方面的生存结局更差。多因素分析显示，年龄≤35岁是5年OS（风险比[HR] = 1.68；95%置信区间[CI]：1.12 - 2.54；P = 0.012）、CSS（HR = 1.74；95% CI：1.15 - 2.65；P = 0.009）和DFS（HR = 1.58；95% CI：1.06 - 2.35；P = 0.024）的独立危险因素。
35岁及以下的年轻CRC患者与老年患者相比预后更差，尤其是对于III期疾病。
