Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 7, 2021; 27(25): 3901-3912
Published online Jul 7, 2021. doi: 10.3748/wjg.v27.i25.3901
Clinical characteristics of patients in their forties who underwent surgical resection for colorectal cancer in Korea
Chang Sin Lee, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim
Chang Sin Lee, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim, Department of Surgery, Korea University College of Medicine, Seoul 02841, South Korea
Author contributions: Lee CS curated data and wrote this manuscript; Kwak JM, Kim J and Kim SH reviewed the paper; Baek SJ mainly provided the main conceptualization.
Institutional review board statement: This study was approved by the Institutional Review Board of Korea University Anam Hospital (No. 2020AN0309).
Informed consent statement: All participants provided informed consent.
Conflict-of-interest statement: There are no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Se-Jin Baek, MD, PhD, Department of Surgery, Korea University College of Medicine, Goryeodae-ro 73, Seongbuk-gu, Seoul 02841, South Korea. xezin@korea.ac.kr
Received: February 5, 2021
Peer-review started: February 5, 2021
First decision: March 14, 2021
Revised: March 27, 2021
Accepted: May 21, 2021
Article in press: May 21, 2021
Published online: July 7, 2021
Abstract
BACKGROUND

The proportion of young patients with colorectal cancer (CRC), especially in their 40s, is increasing worldwide.

AIM

To confirm the clinical characteristics of such patients, we planned a study comparing them to patients in their 30s and 50s.

METHODS

Patients undergoing primary resection for CRC, patients in their 30s, 40s and 50s were included in the study. Patient and tumor characteristics, and perioperative and oncologic outcomes were compared.

RESULTS

Most clinical characteristics of 451 (10.5%) patients in their 40s were more similar to those of patients in their 30s than those in their 50s. On pathology data, there were more metastatic lesions (30s vs 40s vs 50s; 17.5% vs 21.1% vs 14.9%, P = 0.012) in patients in their 40s. There was a trend toward less frequent K-ras mutations among patients in their 40s (48.5% vs 33.3% vs 44.5%, P = 0.064). The proportion of patients receiving postoperative chemotherapy was also significantly greater among patients in their 40s (58.3% vs 63.9% vs 56.3%, P = 0.032). Five-year overall survival (OS) and disease-free survival (DFS) did not differ between the three groups (5-year OS, 92.2% vs 89.8% vs 92.2%, P = 0.804; 5-year total DFS, 98.6% vs 95.7% vs 96.1%, P = 0.754; 5-year local DFS, 98.6% vs 94.3% vs 94.9%, P = 0.579; 5-year systemic DFS, 86.4% vs 87.9 % vs 86.4%, P = 0.908).

CONCLUSION

Patients with CRC in their 40s showed significantly more numerous metastatic lesions. The oncologic outcome of stage 1-3 patients in their 40s was not inferior compared to that of those in their 30s and 50s.

Keywords: Colorectal neoplasm, Young age, Hereditary cancer, Sporadic cancer, Screening

Core Tip: The age at which colorectal cancer is first diagnosed is decreasing worldwide, and colorectal cancer, especially in the 40s is very important. In our study, we found that colorectal cancer patients in their 40s had significantly more metastatic lesions and fewer K-ras mutations. Nevertheless, the oncologic outcome was never inferior compared to patients in their 30s and 50s by stages. We believe this to be a very important clinical message in the current situation.