年轻结直肠癌患者的早期死亡率较高，但长期生存率较好。

Young Patients With Colorectal Cancer Have Higher Early Mortality but Better Long-Term Survival.

机构信息

School of Medicine, Nankai University, Tianjin, China.

Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China.

出版信息

Clin Transl Gastroenterol. 2022 Dec 1;13(12):e00543. doi: 10.14309/ctg.0000000000000543.

DOI:10.14309/ctg.0000000000000543

PMID:36579781

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9780114/

Abstract

INTRODUCTION

To define the prognosis of colorectal cancer (CRC) in young patients and to compare their postoperative treatment with that of older patients.

METHODS

This multicenter study enrolled 5,457 patients with primary CRC who underwent surgical resection. The overall survival (OS), clinicopathologic characteristics, and postoperative treatment of 253 young patients aged 18-44 years and 5,204 older patients aged 44-80 years were analyzed.

RESULTS

The OS rate was 77.1% for young and 74.2% for older patients (P = 0.348). Landmark analysis showed a significant difference in survival between young and older patients, with 63.8% of deaths among young patients being within 25 months of surgery compared with 42.4% among older patients (P = 0.002). Among those who survived more than 25 months, young patients had significantly better survival than older patients (P = 0.009). Multivariable analysis of young patients revealed that the tumor location, perineural invasion, and stage were associated with poor survival within 25 months; after this period, stage was the only prognostic marker. Young patients were more likely to receive chemotherapy, particularly multiagent regimens. For young patients, no significant difference in OS was found based on the chemotherapy regimen, regardless of disease stage (II, III, or IV, all P > 0.05). In addition, unlike in older patients, no difference in OS was found in young patients regardless of the drug regimen administered (all P > 0.05).

DISCUSSION

Young-onset CRC may have a unique disease biology that warrants further research and therapy development.

摘要

简介

为了定义年轻患者结直肠癌（CRC）的预后，并比较他们与老年患者的术后治疗。

方法

这项多中心研究纳入了 5457 例接受手术切除的原发性 CRC 患者。分析了 253 例年龄在 18-44 岁的年轻患者和 5204 例年龄在 44-80 岁的老年患者的总生存（OS）、临床病理特征和术后治疗情况。

结果

年轻患者的 OS 率为 77.1%，老年患者为 74.2%（P=0.348）。生存分析显示，年轻和老年患者的生存存在显著差异，年轻患者中 63.8%的死亡发生在手术后 25 个月内，而老年患者中这一比例为 42.4%（P=0.002）。在存活超过 25 个月的患者中，年轻患者的生存明显优于老年患者（P=0.009）。对年轻患者的多变量分析显示，肿瘤位置、神经周围侵犯和分期与 25 个月内的不良预后相关；在此期间之后，分期是唯一的预后标志物。年轻患者更有可能接受化疗，特别是多药联合方案。对于年轻患者，无论疾病分期（II、III 或 IV 期）如何，化疗方案对 OS 均无显著影响（均 P＞0.05）。此外，与老年患者不同，无论使用何种药物方案，年轻患者的 OS 均无差异（均 P＞0.05）。