Are survival rates different for young and older patients with rectal cancer?

Jessica B. O'Connell, Melinda A. Maggard, Jerome H. Liu, David A. Etzioni, Clifford Y. Ko

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101 Scopus citations

Abstract

PURPOSE: Although it is generally believed that young patients with rectal cancer have worse survival rates, no comprehensive analysis has been reported. This study uses a national-level, population-based cancer registry to compare rectal cancer outcomes between young vs. older populations. METHODS: All patients with rectal carcinoma in the Surveillance, Epidemiology, and End Results cancer database from 1991 to 1999 were evaluated. Young (range, 20-40 years; n = 466) and older groups (range, 60-80 years; n = 11,312) were compared for patient and tumor characteristics, treatment patterns, and five-year overall and stage-specific survival. Cox multivariate regression analysis was performed to identify predictors of survival. RESULTS: Mean ages for the groups were 34.1 and 70 years. The young group was comprised of more black and Hispanic patients compared with the older group (P < 0.001). Young patients were more likely to present with late-stage disease (young vs. older: Stage III, 27 vs. 20 percent respectively, P < 0.001; Stage IV, 17.4 vs. 13.6 percent respectively, P < 0.02). The younger group also had worse grade tumors (poorly differentiated 24.3 vs. 14 percent respectively, P < 0.001). Although the majority of both groups received surgery (85 percent for each), significantly more young patients received radiation (P < 0.001). Importantly, overall and stage-specific, five-year survival rates were similar for both groups (P = not significant). CONCLUSIONS: Although previous studies have found young rectal cancer patients to have poorer survival compared with older patients, this population-based study shows that young rectal cancer patients seem to have equivalent overall and stage-specific survival.

Original languageEnglish (US)
Pages (from-to)2064-2069
Number of pages6
JournalDiseases of the colon and rectum
Volume47
Issue number12
DOIs
StatePublished - Dec 1 2004

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Keywords

  • Cancer
  • Population-based
  • Rectal
  • SEER
  • Survival
  • Young

ASJC Scopus subject areas

  • Gastroenterology

Cite this

O'Connell, J. B., Maggard, M. A., Liu, J. H., Etzioni, D. A., & Ko, C. Y. (2004). Are survival rates different for young and older patients with rectal cancer? Diseases of the colon and rectum, 47(12), 2064-2069. https://doi.org/10.1007/s10350-004-0738-1