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Young Vs Old Colorectal Cancer in Indian Subcontinent: a Tertiary Care Center Experience

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Abstract

This study aims to compare patient, tumor, treatment-related factors and survival between young (<45 years) and old (>45 years) Indian colorectal cancer (CRC) patients. Total 778 patients of CRC were registered at tertiary cancer center in India between 1 August 2013 and 31 July 2014. Patients were followed up for median period of 27.73 months. Data regarding patient, tumor, treatment and survival-related factors were collected. Patients were divided in young (≤45 years) and old (>45 years) age groups. Statistical analysis was done with SPSS software version 23. Young age group patients presented more commonly with poor histology, node-positive disease, and rectal site. Younger age group patients received multiple lines of neoadjuvant treatment. There was no significant overall survival difference in both groups of patients. On stratified stage-wise analysis, no significant overall survival (OS) difference was found between two groups (young vs old—1- and 3-year OS: 85.2 and 61.5% vs 81.5 and 64.5%, respectively; P = 0.881). On univariate analysis, gender, performance status, site, stage, differentiation, TRG, CRM status, signet ring type, and CEA level were significant prognostic factors. In disease-free survival (DFS) analysis, it is found that there is statistically significant difference in DFS (young vs old: 1 and 3 years; 77.6 and 62.8% vs 85.8 and 74.1%, respectively; P value, 0.02), but when OS was analyzed for same group of patient, there was no statistical difference (P = 0.302). This study confirms the high incidence rates of CRC in young Indian patients. There is no OS difference between two age groups. In operated group of patients, there is higher DFS in older patients but no OS advantage at 3 years follow-up. Further long-term follow-up is required to see any OS difference.

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References

  1. Fairley TL, Cardinez CJ, Martin J, Alley L, Friedman C, Edwards B et al (2006) Colorectal cancer in U.S. adults younger than 50 years of age, 1998–2001. Cancer 107(5 Suppl):1153–1161

    Article  PubMed  Google Scholar 

  2. Siegel RL, Jemal A, Ward EM (2009) Increase in incidence of colorectal cancer among young men and women in the United States. Cancer Epidemiol Biomark Prev 18:1695–1698

    Article  Google Scholar 

  3. Taylor MC, Pounder D, Ali-Ridha NH, Bodurtha A, MacMullin EC (1988) Prognostic factors in colorectal carcinoma of young adults. Can J Surg 31:150–153

    CAS  PubMed  Google Scholar 

  4. Cusack JC, Giacco GG, Cleary K, Davidson BS, Izzo F, Skibber J et al (1996) Survival factors in 186 patients younger than 40 years old with colorectal adenocarcinoma. J Am Coll Surg 183:105–112

    CAS  PubMed  Google Scholar 

  5. Fu J, Yang J, Tan Y, Jiang M, Wen F, Huang Y et al (2014) Young patients (≤35 years old) with colorectal cancer have worse outcomes due to more advanced disease: a 30-year retrospective review. Medicine 93(23):e135

    Article  PubMed  PubMed Central  Google Scholar 

  6. Heys SD, Sherif A, Bagley JS, Brittenden J, Smart C, Eremin O (1994) Prognostic factors and survival of patients aged less than 45 years with colorectal cancer. Br J Surg 81:685–688

    Article  CAS  PubMed  Google Scholar 

  7. Lee PY, Fletcher WS, Sullivan ES, Vetto JT (1994) Colorectal cancer in young patients: characteristics and outcome. Am Surg 60:607–612

    CAS  PubMed  Google Scholar 

  8. Oconell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY (2003) Rates of colon and rectal cancers are increasing in young adults. Am Surg 69:866–872

    Google Scholar 

  9. Bailey CE, Hu C-Y, You YN et al (2015) Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975–2010. JAMA Surg 150:17–22

    Article  PubMed  PubMed Central  Google Scholar 

  10. O’Connell JB, Maggard MA, Livingston EH, Yo CK (2004) Colorectal cancer in the young. Am J Surg 187:343–348

    Article  PubMed  Google Scholar 

  11. Laskar RS, Talukdar FR, Mondal R, Kannan R, Ghosh SK (2014) High frequency of young age rectal cancer in a tertiary care centre of southern Assam, North East India. Indian J Med Res 139(2):314–318

    PubMed  PubMed Central  Google Scholar 

  12. Gupta S, Bhattacharya D, Acharya AN, Majumdar S, Ranjan P, Das S (2010) Colorectal carcinoma in young adults: a retrospective study on Indian patients: 2000-2008. Color Dis 12:e182–e189

    Article  CAS  Google Scholar 

  13. Schellerer VS, Merkel S, Schumann SC, Schlabrakowski A, Förtsch T, Schildberg C et al (2012) Despite aggressive histopathology survival is not impaired in young patients with colorectal cancer: CRC in patients under 50 years of age. Int J Colon Dis 27:71–79

    Article  Google Scholar 

  14. Derwinger K, Kodeda K, Gerjy R (2010) Age aspects of demography, pathology and survival assessment in colorectal cancer. Anticancer Res 30:5227–5231

    PubMed  Google Scholar 

  15. Ganapathi S, Kumar D, Katsoulas N, Melville D, Hodgson S, Finlayson C et al (2011) Colorectal cancer in the young: trends, characteristics and outcome. Int J Color Dis 26:927–934

    Article  Google Scholar 

  16. Ballester V, Rashtak S, Boardman L (2016) Clinical and molecular features of young onset colorectal cancer. World J Gastroenterol 22(5):1736–1744

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Sargent DJ, Wieand HS, Haller DG, Gray R, Benedetti JK, Buyse M et al (2005) Disease-free survival versus overall survival as a primary end point for adjuvant colon cancer studies: individual patient data from 20,898 patients on 18 randomized trials. J Clin Oncol 23(34):8664–8670

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgical Oncology, Tata Memorial Hospital, Dr Earnest Borges Road., Parel, Mumbai, 400012, India

    Ashish B. Pokharkar, Manish Bhandare & Avanish P. Saklani

  2. Department of Gastroenterology, Tata Memorial Hospital, Dr Earnest Borges Road., Parel, Mumbai, 400012, India

    Prachi Patil & Shaesta Mehta

  3. Department of Radiation Oncology, Tata Memorial Hospital, Dr Earnest Borges Road., Parel, Mumbai, 400012, India

    Reena Engineer

Authors
  1. Ashish B. Pokharkar
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  2. Manish Bhandare
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  3. Prachi Patil
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  4. Shaesta Mehta
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  5. Reena Engineer
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  6. Avanish P. Saklani
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Correspondence to Avanish P. Saklani.

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Pokharkar, A.B., Bhandare, M., Patil, P. et al. Young Vs Old Colorectal Cancer in Indian Subcontinent: a Tertiary Care Center Experience. Indian J Surg Oncol 8, 491–498 (2017). https://doi.org/10.1007/s13193-017-0670-1

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  • DOI: https://doi.org/10.1007/s13193-017-0670-1

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