Patients with colon cancer who are younger than 25 may have worse survival outcomes than do older patients, according to the results of a recent study reported in the Journal of the American College of Surgeons.

The study entailed a comparison of patient records from the University of Texas MD Anderson Cancer Center in Houston, Texas, spanning the time from January 1991 through February 2017. Survival outcomes were compared for 2 cohorts stratified by age at diagnosis, with younger patients (n=94) being younger than 25 years and adult patients (n=765) being older than 25 years.

Younger patients had lower overall survival (OS) and recurrence-free survival (RFS) rates at both 3 and 5 years. The 5-year OS rate for younger patients was 44% (95% CI, 33%-58%), compared with 84% (95% CI, 81%-87%) for the adult cohort. The 5-year RFS rate for younger patients was 27% (95% CI, 18%-40%), and for adult patients it was 74% (95% CI, 71%-77%).

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At 5 years, the OS and RFS rates were reported to be generally worse for younger patients than for adults in comparisons across stages of disease. Younger patients also showed significantly more peritoneal metastasis (P =.00001) and more often had poorly differentiated tumors.

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“This is the first time peritoneal metastasis has been shown to be statistically significantly more prevalent in pediatric patients with colon cancer,” the study investigators wrote in their report. They concluded that younger patients with colon cancer in this study showed worse survival across stages, for undetermined reasons.


Hayes-Jordan AA, Sandler G, Malakord S, Xiao LC, Kopetz S, Rodriquez-Bigas M. Colon cancer in patients under 25 years old: a different disease?J Am Coll Surg. Published online February 21, 2020. doi: 10.1016/j.jamcollsurg.2019.12.043