Skip to main content

Advertisement

Log in

Clinicopathological characteristics of young patients with sporadic colorectal cancer

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the clinicopathological features of and prognosis associated with sporadic colorectal cancer (CRC) in Japanese patients younger than 40 years old.

Methods

The subjects of this study were patients with sporadic stage 0–III CRC, who underwent curative resection between 2004 and 2012 at the Cancer Institute Hospital. Clinicopathological characteristics and survival were compared between the young (<40 years; n = 81) and older groups (≥40 years; n = 2257).

Results

The median age was 36 years in the young group and 64 years in the older group. Young patients had a lower incidence of right-sided colon cancer (14 vs 28 %) and a higher incidence of rectal cancer (47 vs 32 %; P < 0.0001). The number of retrieved lymph nodes was significantly higher in the young group than in the older group (P = 0.0049). The young patients had similar overall survival and relapse-free survival to their older counterparts, except for overall survival in stage II patients (P = 0.0229). However, multivariate analysis indicated that age was not an independent prognostic factor for overall survival in patients with stage II CRC.

Conclusions

Young Japanese patients with sporadic CRC have unique characteristics such as a high incidence of rectal cancer and similar pathological features; however, they appear to have comparable survival to older patients.

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

Access this article

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ferlay J, Shin H-R, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–917.

    Article  CAS  PubMed  Google Scholar 

  2. Taggarshe D, Rehil N, Sharma S, Flynn JC, Damadi A. Colorectal cancer: are the “young” being overlooked? Am. J. Surg. 2013;205:312–6 (discussion 316).

  3. Matsuda A, Matsuda T, Shibata A, Katanoda K, Sobue T Nishimoto H, TJCSRG. Cancer Incidence and Incidence Rates in Japan in 2008: a study of 25 population-based cancer registries for the monitoring of cancer incidence in Japan (MCIJ) Project. Jpn. J. Clin. Oncol. 2013;44:388–96.

  4. Services C for CC and I, National Cancer Center J. Vital Statistics Japan (Ministry of Health, Labour and Welfare). 2013.

  5. Minardi AJ, Sittig KM, Zibari GB, McDonald JC. Colorectal cancer in the young patient. Am Surg. 1998;64:849–53.

    PubMed  Google Scholar 

  6. Palmer ML, Herrera L, Petrelli NJ. Colorectal adenocarcinoma in patients less than 40 years of age. Dis Colon Rectum. 1991;34:343–6.

    Article  CAS  PubMed  Google Scholar 

  7. Marble K, Banerjee S, Greenwald L. Colorectal carcinoma in young patients. J Surg Oncol. 1992;51:179–82.

    Article  CAS  PubMed  Google Scholar 

  8. Chou C-L, Chang S-C, Lin T-C, Chen W-S, Jiang J-K, Wang H-S, et al. Differences in clinicopathological characteristics of colorectal cancer between younger and elderly patients: an analysis of 322 patients from a single institution. Am J Surg. 2011;202:574–82.

    Article  PubMed  Google Scholar 

  9. Gallagher EG, Zeigler MG. Rectal carcinoma in patients in the second and third decades of life. Am J Surg. 1972;124:655–9.

    Article  CAS  PubMed  Google Scholar 

  10. Yeo SA, Chew MH, Koh PK, Tang CL. Young colorectal carcinoma patients do not have a poorer prognosis: a comparative review of 2,426 cases. Tech. Coloproctol. 2013;17:653–61.

  11. O’Connell JB, Maggard MA, Liu JH, Etzioni DA, Ko CY. Are survival rates different for young and older patients with rectal cancer? Dis. Colon Rectum. 2004;47:2064–9.

  12. Giardiello FM, Allen JI, Axilbund JE, Boland CR, Burke CA, Burt RW, et al. Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the US Multi-Society Task Force on colorectal cancer. Gastroenterology. 2014;147:502–26.

    Article  PubMed  Google Scholar 

  13. Li Q, Cai G, Li D, Wang Y, Zhuo C, Cai S. Better long-term survival in young patients with non-metastatic colorectal cancer after surgery, an analysis of 69,835 patients in SEER database. PLoS One. 2014;9:e93756.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Steele SR, Park GE, Johnson EK, Martin MJ, Stojadinovic A, Maykel JA, et al. The impact of age on colorectal cancer incidence, treatment, and outcomes in an equal-access health care system. Dis. Colon Rectum. 2014;57:303–10.

  15. Mitry E, Benhamiche AM, Jouve JL, Clinard F, Finn-Faivre C, Faivre J. Colorectal adenocarcinoma in patients under 45 years of age: comparison with older patients in a well-defined French population. Dis. Colon Rectum. 2001;44:380–7.

  16. Yang Z, Kang L, Wang L, Xiang J, Cai G, Cui J, et al. Characteristics and long-term survival of colorectal cancer patients aged 44 years and younger. Clin Transl Oncol. 2012;14:896–904.

    Article  PubMed  Google Scholar 

  17. Liang JT, Huang KC, Cheng AL, Jeng YM, Wu MS, Wang SM. Clinicopathological and molecular biological features of colorectal cancer in patients less than 40 years of age. Br J Surg. 2003;90:205–14.

    Article  CAS  PubMed  Google Scholar 

  18. Lee PY, Fletcher WS, Sullivan ES, Vetto JT. Colorectal cancer in young patients: characteristics and outcome. Am Surg. 1994;60:607–12.

    CAS  PubMed  Google Scholar 

  19. Chiang J-M, Chen M-C, Changchien CR, Chen J-S, Tang R, Wang J-Y, et al. Favorable influence of age on tumor characteristics of sporadic colorectal adenocarcinoma: patients 30 years of age or younger may be a distinct patient group. Dis Colon Rectum. 2003;46:904–10.

    Article  PubMed  Google Scholar 

  20. Li M, Li J-Y, Zhao A-L, Gu J. Do young patients with colorectal cancer have a poorer prognosis than old patients? J. Surg. Res. Elsevier Inc; 2011;167:231–6.

  21. Schellerer VS, Merkel S, Schumann SC, Schlabrakowski A, Förtsch T, Schildberg C, et al. Despite aggressive histopathology survival is not impaired in young patients with colorectal cancer. Int J Colorectal Dis. 2012;27:71–9.

    Article  PubMed  Google Scholar 

  22. Cusack JC, Giacco GG, Cleary K, Davidson BS, Izzo F, Skibber J, et al. Survival factors in 186 patients younger than 40 years old with colorectal adenocarcinoma. J Am Coll Surg. 1996;183:105–12.

    CAS  PubMed  Google Scholar 

  23. Howard EW, Cavallo C, Hovey LM, Nelson TG. Colon and rectal cancer in the young adult. Am Surg. 1975;41:260–5.

    CAS  PubMed  Google Scholar 

  24. Griffin PM, Liff JM, Greenberg RS, Clark WS. Adenocarcinomas of the colon and rectum in persons under 40 years old. A population-based study. Gastroenterology. 1991;100:1033–40.

    CAS  PubMed  Google Scholar 

  25. Soliman AS, Bondy ML, Levin B, Hamza MR, Ismail K, Ismail S, et al. Colorectal cancer in Egyptian patients under 40 years of age. Int J Cancer. 1997;71:26–30.

  26. Bülow S. Colorectal cancer in patients less than 40 years of age in Denmark, 1943–1967. Dis Colon Rectum. 1980;23:327–36.

    Article  PubMed  Google Scholar 

  27. Haenszel W, Correa P. Cancer of the large intestine: epidemiologic findings. Dis Colon Rectum. 1973;16:371–7.

    Article  CAS  PubMed  Google Scholar 

  28. Devesa SS, Chow WH. Variation in colorectal cancer incidence in the United States by subsite of origin. Cancer. 1993;71:3819–26.

    Article  CAS  PubMed  Google Scholar 

  29. De Jong UW, Day NE, Muir CS, Barclay TH, Bras G, Foster FH, et al. The distribution of cancer within the large bowel. Int J Cancer. 1972;10:463–77.

    Article  PubMed  Google Scholar 

  30. Gonzalez EC, Roetzheim RG, Ferrante JM, Campbell R. Predictors of proximal vs. distal colorectal cancers. Dis Colon Rectum. 2001;44:251–8.

    Article  CAS  PubMed  Google Scholar 

  31. Yamauchi M, Morikawa T, Kuchiba A, Imamura Y, Qian ZR, Nishihara R, et al. Assessment of colorectal cancer molecular features along bowel subsites challenges the conception of distinct dichotomy of proximal versus distal colorectum. Gut. 2012;61:847–54.

  32. Jimi S-I, Hotokezaka M, Ikeda T, Uchiyama S, Hidaka H, Maehara N, et al. Clinicopathological features, postoperative survival and prognostic variables for cancer-related survival in patients with mucinous colorectal carcinoma. Surg Today. 2015;45:329–34.

    Article  PubMed  Google Scholar 

  33. Leff DR, Chen A, Roberts D, Grant K, Western C, Windsor ACJ, et al. Colorectal cancer in the young patient. Am Surg. 2007;73:42–7.

    PubMed  Google Scholar 

  34. Lin J, Wang W, Yen C, Liu J, Yang M, Chao T, et al. Outcome of colorectal carcinoma in patients under 40 years of age. J Gastroenterol Hepatol. 2005;20:900–5.

    Article  PubMed  Google Scholar 

  35. Wong JH, Severino R, Honnebier MB, Tom P, Namiki TS. Number of nodes examined and staging accuracy in colorectal carcinoma. J Clin Oncol. 1999;17:2896–900.

    CAS  PubMed  Google Scholar 

  36. Joseph NE, Sigurdson ER, Hanlon AL, Wang H, Mayer RJ, MacDonald JS, et al. Accuracy of determining nodal negativity in colorectal cancer on the basis of the number of nodes retrieved on resection. Ann Surg Oncol. 2003;10:213–8.

    Article  PubMed  Google Scholar 

  37. Baxter NN, Virnig DJ, Rothenberger DA, Morris AM, Jessurun J, Virnig BA. Lymph node evaluation in colorectal cancer patients: a population-based study. J Natl Cancer Inst. 2005;97:219–25.

    Article  PubMed  Google Scholar 

  38. Le Voyer TE, Sigurdson ER, Hanlon AL, Mayer RJ, Macdonald JS, Catalano PJ, et al. Colon cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of intergroup trial INT-0089. J Clin Oncol. 2003;21:2912–9.

    Article  PubMed  Google Scholar 

  39. Sarli L, Bader G, Iusco D, Salvemini C, Di Mauro D, Mazzeo A, et al. Number of lymph nodes examined and prognosis of TNM stage II colorectal cancer. Eur J Cancer. 2005;41:272–9.

    Article  PubMed  Google Scholar 

  40. Quah HM, Joseph R, Schrag D, Shia J, Guillem JG, Paty PB, et al. Young age influences treatment but not outcome of colon cancer. Ann Surg Oncol. 2007;14:2759–65.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Takashi Akiyoshi.

Ethics declarations

Conflict of interest

We have no conflicts of interest to declare.

Additional information

A. Murata and T. Akiyoshi contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Murata, A., Akiyoshi, T., Ueno, M. et al. Clinicopathological characteristics of young patients with sporadic colorectal cancer. Surg Today 46, 1166–1175 (2016). https://doi.org/10.1007/s00595-015-1298-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-015-1298-9

Keywords

Navigation