Association of Age and Overall Survival in Surgically Resected Colorectal Cancer Patients

J Surg Res. 2023 Jan:281:321-327. doi: 10.1016/j.jss.2022.08.031. Epub 2022 Oct 11.

Abstract

Introduction: Incidence of colorectal cancer (CRC) among young patients has increased in the last 20 y often with more aggressive tumor biology. It is unclear if age < 50 y is an independent factor for shorter overall survival in CRC patients. Our objective was to determine if younger age at diagnosis was associated with worse overall survival.

Methods: This study used the National Cancer Data Base (2004-2016), retrospectively reviewing patients who underwent surgical resection for CRC. Patients were limited to only those without comorbidities and primary outcome was overall survival for all patients.

Results: Older patients have worse overall survival as compared to younger patients at a lower stage of disease (I and II) after adjusting for tumor location, gender, histology, stage, and systemic chemotherapy (< 36 y old versus 36-55 y old hazard ratio [HR] 1.16, confidence interval [CI] 1.03-1.29). This survival benefit is eliminated at a higher stage of disease, stage III in 36-55 y old versus < 36 y old (HR 0.96 [CI 0.90-1.03.99]) and stage IV (HR 0.94 [CI 0.89-0.99]).

Conclusions: Older patients (aged > 36 y) have worse overall survival at a lower stage of disease, but the survival among all age groups was similar for stage III or IV disease in CRC.

Keywords: Age; Colorectal cancer; NCDB; Overall survival.

MeSH terms

  • Colorectal Neoplasms* / pathology
  • Humans
  • Neoplasm Staging
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies