Pokharkar Ashish B, Bhandare Manish, Patil Prachi, Mehta Shaesta, Engineer Reena, Saklani Avanish P
Department of Surgical Oncology, Tata Memorial Hospital, Dr Earnest Borges Road., Parel, Mumbai, 400012 India.
Department of Gastroenterology, Tata Memorial Hospital, Dr Earnest Borges Road., Parel, Mumbai, 400012 India.
Indian J Surg Oncol. 2017 Dec;8(4):491-498. doi: 10.1007/s13193-017-0670-1. Epub 2017 May 26.
This study aims to compare patient, tumor, treatment-related factors and survival between young (<45 years) and old (>45 years) Indian colorectal cancer (CRC) patients. Total 778 patients of CRC were registered at tertiary cancer center in India between 1 August 2013 and 31 July 2014. Patients were followed up for median period of 27.73 months. Data regarding patient, tumor, treatment and survival-related factors were collected. Patients were divided in young (≤45 years) and old (>45 years) age groups. Statistical analysis was done with SPSS software version 23. Young age group patients presented more commonly with poor histology, node-positive disease, and rectal site. Younger age group patients received multiple lines of neoadjuvant treatment. There was no significant overall survival difference in both groups of patients. On stratified stage-wise analysis, no significant overall survival (OS) difference was found between two groups (young vs old-1- and 3-year OS: 85.2 and 61.5% vs 81.5 and 64.5%, respectively; = 0.881). On univariate analysis, gender, performance status, site, stage, differentiation, TRG, CRM status, signet ring type, and CEA level were significant prognostic factors. In disease-free survival (DFS) analysis, it is found that there is statistically significant difference in DFS (young vs old: 1 and 3 years; 77.6 and 62.8% vs 85.8 and 74.1%, respectively; value, 0.02), but when OS was analyzed for same group of patient, there was no statistical difference ( = 0.302). This study confirms the high incidence rates of CRC in young Indian patients. There is no OS difference between two age groups. In operated group of patients, there is higher DFS in older patients but no OS advantage at 3 years follow-up. Further long-term follow-up is required to see any OS difference.
本研究旨在比较印度年轻（<45岁）和老年（>45岁）结直肠癌（CRC）患者的患者、肿瘤、治疗相关因素及生存率。2013年8月1日至2014年7月31日期间，共有778例CRC患者在印度的三级癌症中心登记。患者的中位随访期为27.73个月。收集了有关患者、肿瘤、治疗及生存相关因素的数据。患者被分为年轻（≤45岁）和老年（>45岁）年龄组。使用SPSS 23软件进行统计分析。年轻年龄组患者更常表现为组织学差、淋巴结阳性疾病和直肠部位。年轻年龄组患者接受了多线新辅助治疗。两组患者的总生存率无显著差异。在分层分期分析中，两组之间未发现显著的总生存（OS）差异（年轻组与老年组1年和3年OS：分别为85.2%和61.5% vs 81.5%和64.5%；P =0.881）。单因素分析中，性别、体能状态、部位、分期、分化程度、肿瘤退缩分级（TRG）、环周切缘状态、印戒细胞类型和癌胚抗原（CEA）水平是显著的预后因素。在无病生存（DFS）分析中，发现DFS存在统计学显著差异（年轻组与老年组：1年和3年；分别为77.6%和62.8% vs 85.8%和74.1%；P值，0.02），但对同一组患者进行OS分析时，无统计学差异（P =0.302）。本研究证实了印度年轻患者中CRC的高发病率。两个年龄组之间无OS差异。在手术患者组中，老年患者的DFS较高，但在3年随访时无OS优势。需要进一步的长期随访以观察是否存在OS差异。
