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Improved survival in an Asian cohort of young colorectal cancer patients: an analysis of 523 patients from a single institution

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Colorectal cancer (CRC) in the young is rare. Outcomes remain varied compared to older populations. The study reviews characteristics and overall survival (OS) of CRC in patients ≤50 years old.

Materials and methods

Five hundred and twenty-three (14%) of 3,796 sporadic CRCs were identified. Patients were compared for demographics, tumour characteristics, treatment, and 5-year overall specific survival. Independent prognostic factors were evaluated.

Results

The majority were males (54%) with a median age of 45 years (range 19–50 years). Sixty-three percent of the patients presented with advanced stage disease (stage III and IV), and tumours were predominantly left-sided (83%). A higher frequency of mucinous or signet ring cell histological subtypes (16% vs 9%, p = 0.028) as well as poorly differentiated tumours (30% vs 12%, p = 0.0001) were present in younger patients ≤40 years. With a median follow-up of 41 months, the 5-year OS is 58% (95% confidence interval 53–64%). Younger patients ≤40 years had significantly superior 5-year OS of 62% vs 58% in the age group 41–50 years old (p = 0.004). Multivariate analysis identified five independent prognostic features: age group of 41–50 years, poorly differentiated tumour grade, presence of perineural infiltration, high tumour stage, and carcinoembryonic antigen values ≥5 ng/ml.

Conclusion

This study has revealed significantly improved 5-year survival in young CRC compared to those reported in the literature.

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Acknowledgements

The authors would like to thank the following people in the preparation of the manuscript: Singapore polyposis registry coordinator, Ms. Carol TT Loi, RN Msc (Healthcare); senior biostatistician of the Department of Clinical Research Singapore General Hospital, Ms. Stephanie MC Fook-Chong, BSc MSc (McGill) CStat; and the rest of the contributory authors to the manuscript: Dr. Jit-Fong Lim, Dr. Kok-Sun Ho, Dr. Boon-Swee Ooi, and Dr. Choong-Leong Tang.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    Min-Hoe Chew, Poh-Koon Koh, Kheng-Hong Ng & Kong-Weng Eu

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  1. Min-Hoe Chew
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  2. Poh-Koon Koh
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  3. Kheng-Hong Ng
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Correspondence to Kong-Weng Eu.

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Chew, MH., Koh, PK., Ng, KH. et al. Improved survival in an Asian cohort of young colorectal cancer patients: an analysis of 523 patients from a single institution. Int J Colorectal Dis 24, 1075–1083 (2009). https://doi.org/10.1007/s00384-009-0701-7

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  • DOI: https://doi.org/10.1007/s00384-009-0701-7

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