Colorectal Cancer in Upper Egypt, Does Age Make A Difference in Survival ?, HODA H. EISA
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- Category: Vol. 78, March 2010
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Colorectal Cancer in Upper Egypt, Does Age Make A Difference in Survival ?, HODA H. EISA
HODA H. EISA, M.D.
Abstract
Background: The incidence of colorectal cancer (CRC) in patients under 40 years in Egypt is rising. However, the prognosis in this subset of patients is controversial. Young age is not yet a poor prognostic marker in CRC.
The Aim of this Study: Was to determine the correlation between age, clinicopathologic features and outcomes of patients with CRC.
Patients and Methods: 102 patients with histologically confirmed CRC were treated between 2004 and 2008 at the Oncology Department of Assiut University Hospital but only (89) patients were eligible for the study. The clinicopathologic features of 36 patients under 40 years (group I) were compared with 53 older patients (group II). Patient gender, Karnofsky performance status (KPS), duration of symptoms, symptoms, stage at presentation, lymph node involvement, site, histologic grade and survival rates were compared.
Results: Patients under 40 years constituted 40.4% of all CRC patients. The male to female ratio was 1.3:1 for group I and 1.5:1 for group II. Most tumours in both groups were located in the rectum (47.2% for group I and 39.6% for group II). Most patients in group I presented with an advanced stage (Dukes’ C and D), constituting 58.3% while most of those patients in group II presented with early stages (Dukes’ A and B) constituting 58.5%. Most patients in group I had worse pathologic features where mucinous/ signet ring and poorly differentiated tumours constituted 41.7% and 25% respectively. Most patients in group II presented with well and moderately differentiated tumours (69.8%). There was no significant difference n survival between the two groups where 2- year survival rate was 83.3% and 71.7% and 5- year survival rate was 38.9% and 30.2% for group I and II respectively. On univariate analysis, tumour stage at presentation. Lymph node involvement and KPS were significantly predictive for overall survival. On multivariate analysis, stage at presentation and KPS were the main independent prognostic factors affecting overall survival of young CRC patients.
Conclusions: The incidence of CRC in young patients in upper Egypt is increasing. Most of the tumours were located in the rectum. Young patients had more advanced stage and worse pathologic features. However, the survival in this young group was not significantly different from the older group. Stage of the tumour, L.N. involvement and KPS were the main prognostic factors for survival.