Lee P Y, Fletcher W S, Sullivan E S, Vetto J T
Department of Surgery, Oregon Health Sciences University, Portland 97201.
Am Surg. 1994 Aug;60(8):607-12.
Controversy still exists regarding the features and prognosis of colorectal cancer in young patients. We reviewed the records of 62 patients 40 years of age and younger with adenocarcinoma of the colon and rectum, treated and followed at our institution between 1968 and 1991. These patients represented 3.1 per cent of our total colorectal patient population during that time period. Their mean age was 34.5 years old, with the youngest patient being 18 years of age. Modified Dukes stages at presentation were 8 per cent A, 20 per cent B, 23 per cent C, and 48 per cent D. Underlying inflammatory bowel disease was present in 21 per cent of patients and was proportionately distributed between high (C and D) and low (A and B) stages. Half of the stage D patients had high grade lesions, compared with only 20 per cent of lower stage patients (P = 0.037). All but two patients had operative exploration; 36 (60%) had complete resection of all gross disease. With a mean follow-up of 98.2 months, the 5-year overall survival for stage A disease was 100 per cent, but dropped to 85, 40, and 7 per cent for stages B, C and D, respectively. Compared to published figures for the general population, younger patients with colon and rectal cancer tend to present at a more advanced stage, but have similar stage-related survival.
关于年轻患者结直肠癌的特征和预后仍存在争议。我们回顾了1968年至1991年间在我们机构接受治疗和随访的62例年龄在40岁及以下的结肠和直肠癌腺癌患者的记录。这些患者占该时间段内我们结直肠患者总数的3.1%。他们的平均年龄为34.5岁，最年轻的患者为18岁。初诊时改良Dukes分期为：A期8%，B期20%，C期23%，D期48%。21%的患者存在潜在的炎症性肠病，且在高分期（C期和D期）和低分期（A期和B期）之间呈比例分布。D期患者中有一半患有高级别病变，而低分期患者中这一比例仅为20%（P = 0.037）。除两名患者外，所有患者均接受了手术探查；36例（60%）实现了所有肉眼可见病变的完全切除。平均随访98.2个月，A期疾病的5年总生存率为100%，但B期、C期和D期分别降至85%、40%和7%。与公布的普通人群数据相比，年轻的结肠和直肠癌患者往往在更晚期就诊，但具有相似的分期相关生存率。
