Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
Division of Minimally Invasive Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
Int J Colorectal Dis. 2023 Jul 11;38(1):191. doi: 10.1007/s00384-023-04488-5.
Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide. In recent years, the proportion of patients diagnosed with CRC at younger ages has increased. The clinicopathological features and oncological outcomes in younger patients with CRC remain controversial. We aimed to analyze the clinicopathological features and oncological outcomes in younger patients with CRC.
We examined 980 patients who underwent surgery for primary colorectal adenocarcinoma between 2006 and 2020. Patients were divided into two cohorts: younger (< 40 years old) and older (≥ 40 years old).
Of the 980 patients, 26 (2.7%) were under the age of 40 years. The younger group had more advanced disease (57.7% vs. 36.6%, p = 0.031) and more cases beyond the transverse colon (84.6% vs. 65.3%, p = 0.029) than the older group. Adjuvant chemotherapy was administered more frequently in the younger group (50% vs. 25.8%, p < 0.01). Relapse-free survival and overall survival were similar between the groups at all stages. Moreover, in stages II and III they were also comparable, regardless of the administration of adjuvant chemotherapy.
Younger patients with CRC have a prognosis equivalent to that of older patients. Further studies are needed to establish the optimal treatment strategies for these patients.
结直肠癌（CRC）是全球癌症相关死亡的主要原因。近年来，被诊断为较年轻年龄 CRC 的患者比例有所增加。较年轻 CRC 患者的临床病理特征和肿瘤学结果仍存在争议。我们旨在分析较年轻 CRC 患者的临床病理特征和肿瘤学结果。
我们检查了 2006 年至 2020 年间接受原发性结直肠腺癌手术的 980 例患者。患者分为两组：较年轻（<40 岁）和较年长（≥40 岁）。
在 980 例患者中，有 26 例（2.7%）年龄在 40 岁以下。年轻组疾病更晚期（57.7%比 36.6%，p=0.031），且横结肠以外的病例更多（84.6%比 65.3%，p=0.029）。年轻组更频繁地接受辅助化疗（50%比 25.8%，p<0.01）。在所有分期中，两组的无复发生存率和总生存率相似。此外，在 II 期和 III 期，无论是否接受辅助化疗，两组的结果也相似。
较年轻的 CRC 患者的预后与较年长的患者相当。需要进一步的研究来为这些患者制定最佳的治疗策略。
