Poor prognosis of young male patients with stage III colorectal cancer: A multicenter retrospective study

Abstract

AbstractBackground and ObjectivesThe number of young patients with colorectal cancer (CRC) is increasing. However, sex‐dependent differences in the prognosis of young CRC remain unknown.MethodsWe investigated patients aged <70 years with stage III CRC treated between January 2000 and December 2010 in 24 Japanese referral hospitals. Patients were divided into subgroups by age of 50 years (early‐onset and late‐onset groups) and sex, and clinical characteristics and survival outcomes were compared. Risk factors associated with poor survival outcomes were also analyzed.ResultsAmong 4758 consecutive patients, 771 (16%) were <50 years. Regardless of sex, there were more patients with rectal cancer and treated with adjuvant chemotherapy in the early‐onset group. Among males, tumors in the early‐onset group were poorly differentiated (p < 0.001), and patients were diagnosed at an advanced N stage (p = 0.010). Among females, there were more patients with left‐sided cancer in the early‐onset group (p < 0.001). Relapse‐free survival (RFS) and overall survival (OS) were worse in the early‐onset group than in the late‐onset group (5‐year RFS rates: 58% and 63%, p = 0.024; 5‐year OS rates: 76% and 81%, p = 0.041, respectively), while there were no age‐dependent differences in the survival outcomes of female CRC patients. A multivariate analysis identified age <50 years as one of the independent risk factors associated with poor RFS in male stage III CRC patients (p = 0.032)ConclusionsYoung male patients with stage III CRC showed poorer survival outcomes than their older counterparts. Therefore, age‐ and sex‐related differences in the incidence of CRC recurrence need to be considered.