A retrospective cohort on the factors affecting the prognosis of colorectal cancer in the young.

Introduction. Coloreclal cancer is the third most common cancer in the world today and usually presents at the 5th decade of life. Of patients with colorectal carcinoma, an estimated 2-6 percent are below 40 years of age. Controversies still exist regarding the features and prognosis of colorectal cancer in young patients. The objectives of this study are to determine a cut-off age wherein there is a significant difference in survival and recurrence, to be able to identify specific features among young and old colorectal cancer patients , and to be able to identify and compare the prognosis of these two groups of patients, in terms of survival and recurrence. Methods. A cross sectional review of 393 patients diagnosed with colorectal carcinoma from September 1998 to June 2004 was obtained from the Colorectal Databank of the St. Luke's Medical Center Research and Biotechnology Division. Data on age, gender, location of tumor, histologic data, staging, CEA level, adjuvant treatment were analyzed. Since no other factors met the eligibility criteria for multivariate Cox regression, only age seems to be the significant predictor of colorectal cancer survival and recurrence. Results. The age groups <41 and >41 were found to have the most significant statistical difference in terms of colorectal survival and recurrence using the Log Rank test. In the younger age group, the risk of dying within 5 years is 2.40 times higher and the risk for recurrence is 3.78 times higher than the older age group by univariate cox regression. Data for age and stage of disease at the time of diagnosis revealed that more of the patients below the cut-off age of 41 were diagnosed in the advance stage. Conclusion. The results of this analysis indicate that patients under 41 years of age with colorectal cancer have a more advanced stage at presentation. In both survival and recurrence, they have a poorer outcome compared to older patients. (Author)