Multivariate analysis of prognostic factors in colorectal cancer patients with different ages / 中华肿瘤杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the prognostic factors of young, middle-age and old-age colorectal cancer patients in order to improve the treatment in the future.</p><p><b>METHODS</b>Colorectal cancer patients (n = 842) who had undergon curative resection were divided into three groups according their age young group (< or = 40 years), middle-age group (41 to 64 years) and old group (> o = 65 years). Thirty-five clinical factors in the three groups were analyzed and compared by univariate survival and multivariate analysis. Cox proportional hazards regression model was used with SPSS statistic software.</p><p><b>RESULTS</b>The overall 5-, 10- and 15-year survival rates were 66.3%, 54.2% and 48.5% respectively. The 5- and 10-year survival rates were 53.0% and 42.7% in the young group, which were lower than those in the other two groups. Cox proportional hazards regression model demonstrated that Dukes stage and family history of cancer were common prognostic factors in both young and middle-age groups; chronic constipation was an independent prognostic factor in middle-age group; bowel obstruction, length of operating time and number of metastatic lymph nodes were prognostic factors in the older group. In the young group, the symptomatic duration was not demonstrated as a prognostic factor. The 5- and 10-year survival rates were 82.6% and 64.5% in Dukes A stage; 73.3% and 67.4% in B stage; 37.3% and 27.0% in C stage; 33.3% and 22.2% in D stage. The survival rates in Dukes A and B stages were similar, but in Dukes C and D stages they were lower than those of the middle-age and older groups if the patient had the same stage of disease. In the young colorectal cancer patients with family cancer history, the 5- and 10-year survival rates were 73.1% and 64.5%, which were better than those of patients without it (48.1% and 37.3%).</p><p><b>CONCLUSION</b>In young colorectal cancer patients, the survival rate is lower than those in the middle-age and old patients. Family cancer history and/or advanced Dukes stage are poor prognostic factors, whereas the symptomatic duration is not demonstrated as a poor prognostic factor. The prognostic factors affecting the survival after surgical treatment may be different in different age groups of colorectal cancer patients.</p>