The impact of young age on cancer-specific and non-cancer-related survival after surgery for colorectal cancer: 10-year follow-up

BACKGROUND: It has been reported that although young patients present with more advanced disease, when adjusted for stage, cancer-specific survival is not different after surgery for colorectal cancer. However, few studies have examined non-cancer survival in young patients and 10-year survival has rarely been reported. Moreover, the largest study included patients of old age as a comparator. The aim of this study was to compare cancer-specific and non-cancer-related survival at 10 years in a young age cohort and a middle age cohort in patients undergoing surgery for colorectal cancer. METHODS: Two thousand and seventy seven patients who underwent surgery for colorectal cancer between 1991 and 1994 in 11 hospitals in Scotland were included in the study. Ten-year cancer-specific and non-cancer-related survival and the hazard ratios (HR) were calculated according to age groups (< 45/45-54/55-64/65-74 years). RESULTS: On follow-up, 1066 patients died of their cancer and 369 died of non-cancer-related causes. At 10 years, overall survival was 32%, cancer-specific was 45%, and non-cancer-related survival was 72%. On multivariate analysis of all factors, sex (HR 0.77, 95% CI 0.68-0.88, P < 0.001), mode of presentation (HR 1.64, 95% CI 1.44-1.87, P < 0.01), Dukes' stage (HR 2.69, 95% CI 2.49-2.90, P < 0.001), and specialisation (HR 1.24, 95% CI 1.04-1.44, P < 0.01) were independently associated with cancer-specific survival. On multivariate analysis of all factors, age (HR 2.46, 2.04-2.97, P < 0.001), sex (HR 0.56, 0.45-0.70, P < 0.001), and deprivation (HR 1.16, 1.10-1.24, P < 0.001) were independently associated with non-cancer-related survival. CONCLUSION: The results of this study confirm that young age does not have a negative impact on cancer-specific survival. Moreover, they show that, with 10-year follow-up, young age does not have a negative impact on non-cancer-related survival. British Journal of Cancer (2009) 101, 557-560. doi: 10.1038/sj.bjc.6605222 www.bjcancer.com (C) 2009 Cancer Research UK