Clinical characteristics and prognosis of young patients with colorectal cancer in Eastern China

AIM:To explore the clinical characteristics and prognosis of young patients with colorectal cancer patients in Eastern China.METHODS:A total of 1335 patients with colorectal cancer treated from December 1985 to December 2005at the Second Affiliated Hospital of Zhejiang University School of Medicine were studied retrospectively.The patients were divided into two groups,a younger group(aged≤30 years)and an older group(aged>30 years),and comparison was made in the clinical characteristics and prognosis between the two groups.Chisquare test was used for data analysis of all categorical variables,and overall survival(OS)was calculated by the Kaplan-Meier method.A multivariate analysis was performed using the Cox model.RESULTS:There were 42(3.1%)and 1293(96.9%)cases in the younger group and older group,respectively.Univariate analysis showed that the 5-and10-year OS in the younger group were 33.9%and26.1%,respectively,and those in the older group were60.1%and 52.2%,respectively.Younger group had poor survival(χ2=14.146,P=0.000).Multivariate analysis revealed that age was not a dependent factor for prognosis(OR=0.866,95%CI:0.592-1.269,P=0.461).Stratified analysis indicated that in stageⅢandⅣdisease,the 5-and 10-year OS were 24.6%and14.8%in the younger group,and 40.4%and 33.3%in the older group,respectively,with a significant difference between the two groups(χ2=5.101,P=0.024).In the subgroup of radical surgery,the 5-and 10-year OS were 44.3%and 34.2%in the younger group,and69.6%and 60.5%in the older group,with a difference being significant between the two groups(χ2=7.830,P=0.005).CONCLUSION:Compared with older patients,the younger patients have lower survival,especially in the subgroups of stageⅢandⅣdisease and radical surgery.

Predictors of lymph-node metastasis in surgically resected T1 colorectal cancer in Western populations

Background:The risk of lymph-node metastasis(LNM)in T1 colorectal cancer(CRC)has not been well documented in heterogeneous Western populations.This study investigated the predictors of LNM and the long-term outcomes of patients by analysing T1 CRC surgical specimens and patients’demographic data.Methods:Patients with surgically resected T1 CRC between 2004 and 2014 were identified from the Surveillance,Epidemiology,and End Results(SEER)database.Patients with multiple primary cancers,with neoadjuvant therapy,or without a confirmed histopathological diagnosis were excluded.Multivariate logistic-regression analysis was used to identify the predictors of LNM.Results:Of the 22,319 patients,10.6%had a positive lymph-node status based on the final pathology(nodal category:N19.6%,N21.0%).Younger age,female sex,Asian or African-American ethnicity,poor differentiation,and tumor site outside the rectum were significantly associated with LNM.Subgroup analyses for patients stratified by tumor site suggested that the rate of positive lymph-node status was the lowest in the rectum(hazard ratio:0.74;95%confidence interval:0.63–0.86).Conclusion:The risk of LNM was potentially lower in Caucasian patients than in API or African-American patients with surgically resected T1 CRC.Regarding the T1 CRC site,the rectum was associated with a lower risk of LNM.