A Clinical Analysis of Colorectal Cancer in Young and Elderly Patients

Kim, Hyeong Rok; Kim, Young Jin; Lee, Jung Hun; Kim, Dong Yi; Kim, Shin Kon

Abstract

Colorectal carcinoma in patients under 40 years and over 70 years of age is unusual but not rare. The prognosis of these two groups, compared with remainder of patients, is thought to be unfavorable. From Jan. 1981 to Dec. 1997, 541 patients with primary colorectal cancer who were treated by surgical resection were analyzed retrospectively. They were divided into three age groups according to the age at admission, i.e. under 40 years, over 70 years and between 40 and 69 years(control group). Among three age groups, sex ratio, tumor characteristics(size, location , depth of invasion, lymph node metastasis, liver metastasis, peritoneal metastasis, histopathologic classification, stage, DNA ploidy pattern), serum CEA level and survival were compared and analyzed. The results were as follows: 1) In the young patient group(52 cases), female predominence, large tumor size, high proportion of mucinous adenocarcinoma in histopathologic classification, more frequent metastasis to regional lymph node, frequent peritoneal metastasis and high incidence in tumor location at transverse colon were noted(p<0.05). 2) In the elderly group(69 cases), deep invasion of tumor(T4) was noted (p<0.05). In addition, among them, concomittent diseases were presented in 25 patients(36%). They were diabetes(8), cardiac arrhythmia(4), old myocardial infarction(2), liver cirrhosis(5), COPD(3), previous cancer(3). 3) The 5-year survival rates of the young patient group and that of elderly patient group were lower than that of the other(p<0.01). 4) There was no significant differences in liver metastasis, tumor stage, DNA ploidy pattern, serum CEA level among three age groups.