Skip to main content
Springer Nature Link
Log in

Poor prognosis of young patients with colorectal cancer: a retrospective study

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The present study aimed to explore the survival outcomes of patients with colorectal cancer (CRC) aged 35 years and younger.

Methods

This retrospective cohort study included a total of 995 patients with CRC treated between January 2003 and September 2011. The patients were assorted into the young (aged 18–35 years) and older (aged 36–75 years) groups. The clinical characteristics and survival outcomes of the patients in the young group were compared with those of the patients in the older group for evaluation.

Results

Compared with the older group, a significantly higher number of patients in the young group had right-sided colon cancer (30.9 vs. 19.6%, P = 0.026), high histologic grade tumor (14.7 vs. 6.4%, P = 0.021), and stage III disease (50.0 vs. 35.5%, P = 0.016). In stage III disease, compared with the older group, the patients in the young group had worse survival outcome in terms of 5-year overall survival (OS, P = 0.007), cancer-specific survival (CSS, P = 0.010), and disease-free survival (DFS, P = 0.039). Multivariate analysis revealed that age ≤35 years was an independent risk factor in terms of 5-year OS (hazard ratio [HR] = 1.68; 95% confidence interval [CI]: 1.12–2.54; P = 0.012), CSS (HR = 1.74; 95% CI: 1.15–2.65; P = 0.009), and DFS (HR = 1.58; 95% CI: 1.06–2.35; P = 0.024).

Conclusions

The young patients with CRC aged 35 years and younger had worse prognosis compared with older patients, especially for stage III disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics, 2012. CA Cancer J Clin 65(2):87–108. doi:10.3322/caac.21262

    Article  PubMed  Google Scholar 

  2. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J (2016) Cancer statistics in China, 2015. CA Cancer J Clin 66(2):115–132. doi:10.3322/caac.21338

  3. Edwards BK, Ward E, Kohler BA, Eheman C, Zauber AG, Anderson RN, Jemal A, Schymura MJ, Lansdorp-Vogelaar I, Seeff LC, van Ballegooijen M, Goede SL, Ries LA (2010) Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer 116(3):544–573. doi:10.1002/cncr.24760

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ahnen DJ, Wade SW, Jones WF, Sifri R, Mendoza Silveiras J, Greenamyer J, Guiffre S, Axilbund J, Spiegel A, You YN (2014) The increasing incidence of young-onset colorectal cancer: a call to action. Mayo Clin Proc 89(2):216–224. doi:10.1016/j.mayocp.2013.09.006

    Article  PubMed  Google Scholar 

  5. You YN, Xing Y, Feig BW, Chang GJ, Cormier JN (2012) Young-onset colorectal cancer: is it time to pay attention? Arch Intern Med 172(3):287–289. doi:10.1001/archinternmed.2011.602

    Article  PubMed  Google Scholar 

  6. Wu QJ, Vogtmann E, Zhang W, Xie L, Yang WS, Tan YT, Gao J, Xiang YB (2012) Cancer incidence among adolescents and young adults in urban Shanghai, 1973–2005. PLoS One 7(8):e42607. doi:10.1371/journal.pone.0042607

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Pourhoseingholi MA (2012) Increased burden of colorectal cancer in Asia. World journal of gastrointestinal oncology 4(4):68–70. doi:10.4251/wjgo.v4.i4.68

    Article  PubMed  PubMed Central  Google Scholar 

  8. Sineshaw HM, Robbins AS, Jemal A (2014) Disparities in survival improvement for metastatic colorectal cancer by race/ethnicity and age in the United States. Cancer causes & control : CCC 25(4):419–423. doi:10.1007/s10552-014-0344-z

    Article  PubMed  Google Scholar 

  9. Ashktorab H, Paydar M, Namin HH, Sanderson A, Begum R, Brim H, Panchal H, Lee E, Kibreab A, Nouraie M, Laiyemo AO (2014) Prevalence of colorectal neoplasia among young African Americans and Hispanic Americans. Dig Dis Sci 59(2):446–450. doi:10.1007/s10620-013-2898-0

    Article  PubMed  Google Scholar 

  10. Chan KK, Dassanayake B, Deen R, Wickramarachchi RE, Kumarage SK, Samita S, Deen KI (2010) Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and long-term: analysis of survival and prognostic markers. World journal of surgical oncology 8:82. doi:10.1186/1477-7819-8-82

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Kaplan MA, Isikdogan A, Gumus M, Arslan UY, Geredeli C, Ozdemir N, Koca D, Dane F, Suner A, Elkiran ET, Kucukoner M, Seker M, Helvaci K, Guler T, Uncu D, Inal A, Yildiz R (2013) Childhood, adolescents, and young adults (</=25 y) colorectal cancer: study of Anatolian Society of Medical Oncology. J Pediatr Hematol Oncol 35(2):83–89. doi:10.1097/MPH.0b013e31827e7f20

    Article  PubMed  Google Scholar 

  12. Li M, Li JY, Zhao AL, Gu J (2011) Do young patients with colorectal cancer have a poorer prognosis than old patients? J Surg Res 167(2):231–236. doi:10.1016/j.jss.2010.10.040

    Article  PubMed  Google Scholar 

  13. Taggarshe D, Rehil N, Sharma S, Flynn JC, Damadi A (2013) Colorectal cancer: are the “young” being overlooked? Am J Surg 205(3):312–316; discussion 316. doi:10.1016/j.amjsurg.2012.10.016

  14. Yeo SA, Chew MH, Koh PK, Tang CL (2013) Young colorectal carcinoma patients do not have a poorer prognosis: a comparative review of 2,426 cases. Techniques in coloproctology 17 (6):653–661. doi:10.1007/s10151-013-0977-z

  15. Liang YZ, Yu J, Zhang C, Wang YN, Cheng X, Huang F, Li GX (2010) Construction and application of evaluation system of laparoscopic colorectal surgery based on clinical data mining. Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 13(10):741–744. doi:10.3760/cma.j.issn.1671-0274.2010.10.007

  16. Ueno H, Mochizuki H, Akagi Y, Kusumi T, Yamada K, Ikegami M, Kawachi H, Kameoka S, Ohkura Y, Masaki T, Kushima R, Takahashi K, Ajioka Y, Hase K, Ochiai A, Wada R, Iwaya K, Shimazaki H, Nakamura T, Sugihara K (2012) Optimal colorectal cancer staging criteria in TNM classification. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 30(13):1519–1526. doi:10.1200/JCO.2011.39.4692

    Article  Google Scholar 

  17. Huh JW, Kim YJ, Kim HR (2012) Distribution of lymph node metastases is an independent predictor of survival for sigmoid colon and rectal cancer. Ann Surg 255(1):70–78. doi:10.1097/SLA.0b013e31823785f6

    Article  PubMed  Google Scholar 

  18. Al-Barrak J, Gill S (2011) Presentation and outcomes of patients aged 30 years and younger with colorectal cancer: a 20-year retrospective review. Med Oncol 28(4):1058–1061. doi:10.1007/s12032-010-9639-4

  19. Enblad G, Enblad P, Adami HO, Glimelius B, Krusemo U, Pahlman L (1990) Relationship between age and survival in cancer of the colon and rectum with special reference to patients less than 40 years of age. The British journal of surgery 77(6):611–616. doi:10.1002/bjs.1800770605

  20. Kam MH, Eu KW, Barben CP, Seow-Choen F (2004) Colorectal cancer in the young: a 12-year review of patients 30 years or less. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 6(3):191–194. doi:10.1111/j.1463-1318.2004.00596.x

  21. McMillan DC, McArdle CS (2009) The impact of young age on cancer-specific and non-cancer-related survival after surgery for colorectal cancer: 10-year follow-up. Br J Cancer 101(4):557–560. doi:10.1038/sj.bjc.6605222

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Rodriguez-Bigas MA, Mahoney MC, Weber TK, Petrelli NJ (1996) Colorectal cancer in patients aged 30 years or younger. Surg Oncol 5(4):189–194. doi:10.1016/S0960-7404(96)80043-0

  23. Fu JF, Huang YQ, Yang J, Yi CH, Chen HL, Zheng S (2013) Clinical characteristics and prognosis of young patients with colorectal cancer in Eastern China. World journal of gastroenterology : WJG 19(44):8078–8084. doi:10.3748/wjg.v19.i44.8078

    Article  PubMed  PubMed Central  Google Scholar 

  24. Ciarrocchi A, Amicucci G (2013) Sporadic carcinoma of the colon-rectum in young patients: a distinct disease? A critical review. Journal of gastrointestinal cancer 44(3):264–269. doi:10.1007/s12029-013-9507-5

    Article  PubMed  Google Scholar 

  25. Ganapathi S, Kumar D, Katsoulas N, Melville D, Hodgson S, Finlayson C, Hagger R (2011) Colorectal cancer in the young: trends, characteristics and outcome. Int J Color Dis 26(7):927–934. doi:10.1007/s00384-011-1174-z

    Article  Google Scholar 

  26. Xu A-G (2010) Colorectal cancer in Guangdong Province of China: a demographic and anatomic survey. World J Gastroenterol 16(8):960. doi:10.3748/wjg.v16.i8.960

    Article  PubMed  PubMed Central  Google Scholar 

  27. Shemesh-Bar L, Kundel Y, Idelevich E, Sulkes J, Sulkes A, Brenner B (2010) Colorectal cancer in young patients in Israel: a distinct clinicopathological entity? World J Surg 34(11):2701–2709. doi:10.1007/s00268-010-0748-1

    Article  CAS  PubMed  Google Scholar 

  28. Lo AC, Soliman AS, Khaled HM, Aboelyazid A, Greenson JK (2010) Lifestyle, occupational, and reproductive factors and risk of colorectal cancer. Dis Colon rectum 53 (5):830–837. doi:10.1007/DCR.0b013e3181d320b1

  29. Morrison DS, Batty GD, Kivimaki M, Davey Smith G, Marmot M, Shipley M (2011) Risk factors for colonic and rectal cancer mortality: evidence from 40 years’ follow-up in the Whitehall I study. J Epidemiol Community Health 65(11):1053–1058. doi:10.1136/jech.2010.127555

  30. Ghazi S, Lindforss U, Lindberg G, Berg E, Lindblom A, Papadogiannakis N, Low-Risk Colorectal Cancer Study G (2012) Analysis of colorectal cancer morphology in relation to sex, age, location, and family history. J Gastroenterol 47(6):619–634. doi:10.1007/s00535-011-0520-9

    Article  PubMed  Google Scholar 

  31. Schellerer VS, Merkel S, Schumann SC, Schlabrakowski A, Fortsch T, Schildberg C, Hohenberger W, Croner RS (2012) Despite aggressive histopathology survival is not impaired in young patients with colorectal cancer : CRC in patients under 50 years of age. Int J Color Dis 27(1):71–79. doi:10.1007/s00384-011-1291-8

  32. Chiang JM, Yeh CY, Changchien CR, Chen JS, Tang R, Chen JR (2010) Mucinous adenocarcinoma showing different clinicopathological and molecular characteristics in relation to different colorectal cancer subgroups. Int J Color Dis 25(8):941–947. doi:10.1007/s00384-010-0958-x

    Article  CAS  Google Scholar 

  33. Yamaguchi T, Taniguchi H, Fujita S, Sekine S, Yamamoto S, Akasu T, Kushima R, Tani T, Moriya Y, Shimoda T (2012) Clinicopathological characteristics and prognostic factors of advanced colorectal mucinous adenocarcinoma. Histopathology 61(2):162–169. doi:10.1111/j.1365-2559.2012.04235.x

    Article  PubMed  Google Scholar 

  34. Chou CL, Chang SC, Lin TC, Chen WS, Jiang JK, Wang HS, Yang SH, Liang WY, Lin JK (2011) Differences in clinicopathological characteristics of colorectal cancer between younger and elderly patients: an analysis of 322 patients from a single institution. Am J Surg 202(5):574–582. doi:10.1016/j.amjsurg.2010.10.014

    Article  PubMed  Google Scholar 

  35. Cerdan-Santacruz C, Cano-Valderrama O, Cardenas-Crespo S, Torres-Garcia AJ, Cerdan-Miguel J (2011) Colorectal cancer and its delayed diagnosis: have we improved in the past 25 years? Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 103(9):458–463. doi:10.4321/S1130-01082011000900004

  36. Serra-Rexach JA, Jimenez AB, Garcia-Alhambra MA, Pla R, Vidan M, Rodriguez P, Ortiz J, Garcia-Alfonso P, Martin M (2012) Differences in the therapeutic approach to colorectal cancer in young and elderly patients. Oncologist 17(10):1277–1285. doi:10.1634/theoncologist.2012-0060

    Article  PubMed  PubMed Central  Google Scholar 

  37. Doat S, Thiebaut A, Samson S, Ricordeau P, Guillemot D, Mitry E (2014) Elderly patients with colorectal cancer: treatment modalities and survival in France. National data from the ThInDiT cohort study. Eur J Cancer 50(7):1276–1283. doi:10.1016/j.ejca.2013.12.026

    Article  CAS  PubMed  Google Scholar 

  38. Bailey CE, Hu CY, You YN, Bednarski BK, Rodriguez-Bigas MA, Skibber JM, Cantor SB, Chang GJ (2015) Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975–2010. JAMA surgery 150(1):17–22. doi:10.1001/jamasurg.2014.1756

    Article  PubMed  PubMed Central  Google Scholar 

  39. Li Q, Zhuo C, Cai G, Zheng H, Li D, Cai S (2014) Pathological features and survival outcomes of young patients with operable colon cancer: are they homogeneous? PLoS One 9(7):e102004. doi:10.1371/journal.pone.0102004

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Feng Bao, Liying Zhao, and Guoxin Li designed the research; Feng Bao and Liying Zhao acquired the data of the work, analyzed the data, and drafted the paper; Hao Liu and Guoxin Li revised the paper; and Guoxin Li finally approved the version.

The study was supported by the National Key Clinical Specialty Construction Project of China, the National High Technology Research and Development Program of China (grant no. 2012AA021103), and the Research Fund of Public Welfare in Health Industry (No. 201502039), National Health and Family Planning Commission of China.

Author information

Author notes

  1. Liying Zhao and Feng Bao contributed equally to this work

Authors and Affiliations

  1. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, People’s Republic of China

    Liying Zhao, Feng Bao, Jun Yan, Hao Liu, Tingting Li, Hao Chen & Guoxin Li

  2. Department of General Surgery, Mianyang Central Hospital, Mianyang, People’s Republic of China

    Feng Bao

Authors
  1. Liying Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Feng Bao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jun Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hao Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tingting Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hao Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Guoxin Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guoxin Li.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

ESM 1

(DOCX 17 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhao, L., Bao, F., Yan, J. et al. Poor prognosis of young patients with colorectal cancer: a retrospective study. Int J Colorectal Dis 32, 1147–1156 (2017). https://doi.org/10.1007/s00384-017-2809-5

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-017-2809-5

Keywords