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Shorter survival in adolescent and young adult patients, compared to adult patients, with stage IV colorectal cancer in Japan

BACKGROUND: The incidence of colorectal cancer in adolescent and young adult patients is increasing. However, survival and clinical features of young patients, especially those with stage IV disease, relative to adult patients remain unclear. METHODS: This retrospective single-institution cohort stu...

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Autores principales: Shida, Dai, Ahiko, Yuka, Tanabe, Taro, Yoshida, Takefumi, Tsukamoto, Shunsuke, Ochiai, Hiroki, Takashima, Atsuo, Boku, Narikazu, Kanemitsu, Yukihide
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870248/
https://www.ncbi.nlm.nih.gov/pubmed/29587683
http://dx.doi.org/10.1186/s12885-018-4241-9
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author Shida, Dai
Ahiko, Yuka
Tanabe, Taro
Yoshida, Takefumi
Tsukamoto, Shunsuke
Ochiai, Hiroki
Takashima, Atsuo
Boku, Narikazu
Kanemitsu, Yukihide
author_facet Shida, Dai
Ahiko, Yuka
Tanabe, Taro
Yoshida, Takefumi
Tsukamoto, Shunsuke
Ochiai, Hiroki
Takashima, Atsuo
Boku, Narikazu
Kanemitsu, Yukihide
author_sort Shida, Dai
collection PubMed
description BACKGROUND: The incidence of colorectal cancer in adolescent and young adult patients is increasing. However, survival and clinical features of young patients, especially those with stage IV disease, relative to adult patients remain unclear. METHODS: This retrospective single-institution cohort study was conducted at a tertiary care cancer center. Subjects were 861 consecutive patients who were diagnosed with stage IV colorectal cancer at the age of 15 to 74 years and who were referred to the division of surgery or gastrointestinal oncology at the National Cancer Center Hospital from 1999 to 2013. Overall survival (OS) was investigated and clinicopathological variables were analyzed for prognostic significance. RESULTS: Of these, 66 (8%) were adolescent and young adult patients and 795 (92%) were adult patients. Median survival time was 13.6 months in adolescent and young adult patients and 22.4 months in adult patients, and 5-year OS rates were 17.3% and 20.3%, respectively, indicating significant worse prognosis of adolescent and young adult patients (p = 0.042). However, age itself was not an independent factor associated with prognosis by multivariate analysis. When compared with adult patients, adolescent and young adult patients consisted of higher proportion of the patients who did not undergo resection of primary tumor, which was an independent factor associated with poor prognosis in multivariate analysis. In patients who did not undergo resection (n = 349), OS of adolescent and young adult patients were significantly worse (p = 0.033). CONCLUSIONS: Prognoses were worse in adolescent and young adult patients with stage IV colorectal cancer compared to adult patients in Japan, due to a higher proportion of patients who did not undergo resection with more advanced and severe disease, but not due to age itself.
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spelling pubmed-58702482018-03-29 Shorter survival in adolescent and young adult patients, compared to adult patients, with stage IV colorectal cancer in Japan Shida, Dai Ahiko, Yuka Tanabe, Taro Yoshida, Takefumi Tsukamoto, Shunsuke Ochiai, Hiroki Takashima, Atsuo Boku, Narikazu Kanemitsu, Yukihide BMC Cancer Research Article BACKGROUND: The incidence of colorectal cancer in adolescent and young adult patients is increasing. However, survival and clinical features of young patients, especially those with stage IV disease, relative to adult patients remain unclear. METHODS: This retrospective single-institution cohort study was conducted at a tertiary care cancer center. Subjects were 861 consecutive patients who were diagnosed with stage IV colorectal cancer at the age of 15 to 74 years and who were referred to the division of surgery or gastrointestinal oncology at the National Cancer Center Hospital from 1999 to 2013. Overall survival (OS) was investigated and clinicopathological variables were analyzed for prognostic significance. RESULTS: Of these, 66 (8%) were adolescent and young adult patients and 795 (92%) were adult patients. Median survival time was 13.6 months in adolescent and young adult patients and 22.4 months in adult patients, and 5-year OS rates were 17.3% and 20.3%, respectively, indicating significant worse prognosis of adolescent and young adult patients (p = 0.042). However, age itself was not an independent factor associated with prognosis by multivariate analysis. When compared with adult patients, adolescent and young adult patients consisted of higher proportion of the patients who did not undergo resection of primary tumor, which was an independent factor associated with poor prognosis in multivariate analysis. In patients who did not undergo resection (n = 349), OS of adolescent and young adult patients were significantly worse (p = 0.033). CONCLUSIONS: Prognoses were worse in adolescent and young adult patients with stage IV colorectal cancer compared to adult patients in Japan, due to a higher proportion of patients who did not undergo resection with more advanced and severe disease, but not due to age itself. BioMed Central 2018-03-27 /pmc/articles/PMC5870248/ /pubmed/29587683 http://dx.doi.org/10.1186/s12885-018-4241-9 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Shida, Dai
Ahiko, Yuka
Tanabe, Taro
Yoshida, Takefumi
Tsukamoto, Shunsuke
Ochiai, Hiroki
Takashima, Atsuo
Boku, Narikazu
Kanemitsu, Yukihide
Shorter survival in adolescent and young adult patients, compared to adult patients, with stage IV colorectal cancer in Japan
title Shorter survival in adolescent and young adult patients, compared to adult patients, with stage IV colorectal cancer in Japan
title_full Shorter survival in adolescent and young adult patients, compared to adult patients, with stage IV colorectal cancer in Japan
title_fullStr Shorter survival in adolescent and young adult patients, compared to adult patients, with stage IV colorectal cancer in Japan
title_full_unstemmed Shorter survival in adolescent and young adult patients, compared to adult patients, with stage IV colorectal cancer in Japan
title_short Shorter survival in adolescent and young adult patients, compared to adult patients, with stage IV colorectal cancer in Japan
title_sort shorter survival in adolescent and young adult patients, compared to adult patients, with stage iv colorectal cancer in japan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870248/
https://www.ncbi.nlm.nih.gov/pubmed/29587683
http://dx.doi.org/10.1186/s12885-018-4241-9
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