Younger CRC patients have worse presentation but comparable survival

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Although persons younger than age 50 years with colorectal cancer (CRC) presented with worse histological characteristics and experienced metastasis much sooner than did individuals aged 50 years and older, survival rates for the younger group were as good as or better than those for the older patients, a recent analysis revealed.

The comparison of persons with CRC under and over age 50 years included 4,595 cases from the tumor registry at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania, over a 20-year period (1988 through 2007) and 290,338 cases from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database from 1988 through 2004. Compared with the older patients, the younger group had:

  • more advanced-stage tumors upon presentation
  • more poorly differentiated tumors
  • more mucinous/signet ring cell tumors (particularly younger males)
  • fewer proximal tumors
  • more rectal tumors
  • more positive nodes at all stages
  • more peritoneal metastases but fewer lung metastases.

Yet despite these poor pathologic features, survival for patients under age 50 years was equal to or better than survival among the older study subjects. As noted in a statement issued by Thomas Jefferson University, this may be partially explained by the better overall health of the younger group. According to study coauthor Scott Goldstein, MD, of Jefferson's Department of Surgery, early evidence suggests that younger patients are able to tolerate more aggressive cancer treatments because these individuals have fewer comorbidities.

These findings were presented at the American Society of Clinical Oncology annual meeting, held in Chicago, Illinois, June 1-5, 2012 (Abstract #3621).

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