ABSTRACT
PURPOSE: Colorectal carcinoma (CRC) is generally a disease of persons older than 50 years. Concerning younger patients, controversies still exist regarding features and prognosis of CRC. We performed this study to characterize CRC in young patients (≤50 years) as well as to evaluate outcome in comparison with older patients (>50 years) with CRC. METHODS: Clinical and histopathological parameters of 244 patients aged 50 years or less were compared with 1,718 patients aged more than 50 years. RESULTS: Compared with older patients, the younger had less adenocarcinomas (82.8% vs. 89.1%; p = 0.004) and less postoperative complications (18.4% vs. 28.7%; p = 0.001), and less Union Internationale Contre le Cancer stage I colon cancers (22.9% vs. 13.6%, p = 0.046) but elevated overall 5-year survival rates for M0 colon and rectal cancers (p = 0.005; p < 0.001). In young patients, the minority suffered from hereditary cancer syndromes (7.4%) and inflammatory bowel diseases (7.0%). Furthermore, up to 40% of young patients denied any cancers in their families. Cancer-related survival rates were significantly elevated in young patients with M0 rectal carcinoma (p = 0.014), whereas in M0 colon cancers, no differences were detectable (p = 0.542). In case of the presence of distant metastases, overall and cancer-related survival rates were similar in old and young patients. CONCLUSION: Although young patients present with more aggressive histopathological subtypes and less early stages, cancer-related survival is not less favourable compared with older patients.
Subject(s)
Colorectal Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Child , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/mortality , Colorectal Neoplasms/therapy , Female , Germany/epidemiology , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Neoadjuvant Therapy , Neoplasm Staging , Postoperative Care/mortality , Risk Factors , Survival Analysis , Young AdultABSTRACT
Antiangiogenic drugs have been used successfully for the treatment of colorectal cancer (CRC). Viable tumor endothelial cells (TEC) and normal endothelial cells (NEC) of uninvolved colon tissue of the same patient have not been available to optimize treatment strategies in vitro. Therefore, our target was to establish a protocol for the isolation of TEC and NEC. These cells were isolated with very high purity via magnetic cell sorting of tissue samples obtained from CRC and healthy colon of eight patients. TEC and NEC expressed CD31, CD105, VE-cadherin, VCAM-1, ICAM-1 and E-selectin, formed capillaries in basal membrane extract and were able to take up acetylated low-density lipoprotein. They were negative for podoplanin, CD45, CD68 and cytokeratin-20 indicating blood vessel endothelial lineage. Intense staining of von Willebrand factor (vWF) was observed in five of eight NEC cultures, whereas vWF was absent or only slightly expressed in all TEC cultures in vitro. Low intracellular concentration of vWF was also detected in TEC and NEC at the tissue level. This demonstrated that differences exhibited by TEC and NEC in vivo are stably perpetuated in culture. The isolated cultures may provide a useful in vitro model to elucidate epigenetic effects on angiogenesis in cancer and to optimize antiangiogenic therapy.
