Clinical characteristics of patients in their forties who underwent surgical resection for colorectal cancer in Korea

BACKGROUND The proportion of young patients with colorectal cancer(CRC), especially in their 40 s, is increasing worldwide.AIM To confirm the clinical characteristics of such patients, we planned a study comparing them to patients in their 30 s and 50 s.METHODS Patients undergoing primary resection for CRC, patients in their 30 s, 40 s and 50 s were included in the study. Patient and tumor characteristics, and perioperative and oncologic outcomes were compared.RESULTS Most clinical characteristics of 451(10.5%) patients in their 40 s were more similar to those of patients in their 30 s than those in their 50 s. On pathology data, there were more metastatic lesions(30 s vs 40 s vs 50 s; 17.5% vs 21.1% vs 14.9%, P = 0.012) in patients in their 40 s. There was a trend toward less frequent K-ras mutations among patients in their 40 s(48.5% vs 33.3% vs 44.5%, P = 0.064). The proportion of patients receiving postoperative chemotherapy was also significantly greater among patients in their 40 s(58.3% vs 63.9% vs 56.3%, P = 0.032). Five-year overall survival(OS) and disease-free survival(DFS) did not differ between the three groups(5-year OS, 92.2% vs 89.8% vs 92.2%, P = 0.804; 5-year total DFS, 98.6% vs 95.7% vs 96.1%, P = 0.754; 5-year local DFS, 98.6% vs 94.3% vs 94.9%, P = 0.579; 5-year systemic DFS, 86.4% vs 87.9 % vs 86.4%, P = 0.908).CONCLUSION Patients with CRC in their 40 s showed significantly more numerous metastatic lesions. The oncologic outcome of stage 1-3 patients in their 40 s was not inferior compared to that of those in their 30 s and 50 s.