Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
Saudi J Gastroenterol. 2023 Nov-Dec;29(6):358-364. doi: 10.4103/sjg.sjg_35_23.
Early-onset colorectal cancer (EOCRC) may differ by race and ethnicity, and recently South Korea has witnessed a surge in cases. We aimed to evaluate the clinical and pathological features of patients with EOCRC, and to determine the predictors of overall survival.
In this retrospective study, EOCRC was defined as CRC diagnosed in patients aged < 50 years, and late-onset CRC was defined as CRC diagnosed in those over 75 years of age. The clinical and pathological characteristics of patients with EOCRC were compared with late-onset CRC. We also used multivariable Cox proportional hazard models to find predictors of overall survival in patients with EOCRC.
The proportion of early-onset CRC was 9.1% of 518 patients with CRC, and the clinical and pathological characteristics were similar between early-onset (n = 47) and late-onset CRC (n = 134). However, EOCRC had a preponderance for distal tumor location (70.2% vs. 50.7%, P = 0.02) and T1-2 stage disease (23.4% vs. 11.2%, P = 0.04), compared with those of late-onset CRC. Using multivariable Cox proportional hazard models, only vascular invasion (hazard ratio = 8.75, 95% confidence interval 1.139‒67.197) was found to be a risk factor for overall survival (P = 0.04) for patients with CRC.
EOCRC had preponderance for distal tumor location and early T-stage disease, compared with late-onset CRC. Considering the increasing incidence of EOCRC, more studies on clinical and pathological characteristics of EOCRC may be warranted.
早发性结直肠癌(EOCRC)可能因种族和民族而异,最近韩国的病例数激增。我们旨在评估 EOCRC 患者的临床和病理特征,并确定总体生存率的预测因素。
在这项回顾性研究中,EOCRC 被定义为诊断年龄<50 岁的 CRC 患者,而晚发性 CRC 则定义为诊断年龄>75 岁的 CRC 患者。比较了 EOCRC 患者与晚发性 CRC 患者的临床和病理特征。我们还使用多变量 Cox 比例风险模型来寻找 EOCRC 患者总体生存率的预测因素。
518 例 CRC 患者中 EOCRC 的比例为 9.1%,EOCRC 患者(n=47)和晚发性 CRC 患者(n=134)的临床和病理特征相似。然而,与晚发性 CRC 相比,EOCRC 远端肿瘤位置(70.2% vs. 50.7%,P=0.02)和 T1-2 期疾病(23.4% vs. 11.2%,P=0.04)更为常见。使用多变量 Cox 比例风险模型,仅血管侵犯(风险比=8.75,95%置信区间 1.139-67.197)被发现是 CRC 患者总体生存率的危险因素(P=0.04)。
与晚发性 CRC 相比,EOCRC 远端肿瘤位置和早期 T 期疾病更为常见。考虑到 EOCRC 的发病率不断增加,可能需要对 EOCRC 的临床和病理特征进行更多研究。