Age-related disparity in patients with colorectal cancer: a population-based study from SEER program

作者:Zhuang, Yafei; Liu, Yinyin; Zhao, Hong; Zhou, Shuliang; Xiao, Youde; Zhou, Fuxiang*
来源:International Journal of Clinical and Experimental Medicine, 2017, 10(2): 3305-3312.

摘要

Background & Aims: To analyze the age-related disparity in patients with colorectal cancer (CRC). Methods: Using data obtained by the Surveillance, Epidemiology, and End Results (SEER) program from 2000-2013, a retrospective, population-based cohort study was conducted to investigate age-specific differences in various characteristics, overall survival (OS) and disease-specific mortality (DSM). Results: A total of 262372 CRC patients (2739 patients with age < 35 years, 23094 in 35-49 group, 74605 in 50-64 group and 161934 in >= 65 group) were eligible for this study. Patients with age >= 65 were more likely to be female and white (each P < 0.01). And the older patients were more likely to be lower in grade, earlier in stage, smaller in size, have less lymph node and distant metastases (each P < 0.05). Further, the older patients were more likely to primary derive from Cecum, Ascending, Hepatic Flexure and Transverse patterns (P < 0.05). The younger patients were more likely to diagnose liver metastasis than the older, whereas the older cases were less likely to appeared lung metastases compared to the younger (P < 0.05). At the follow-up period, patients with age >= 65 had an OS of 44.3%, while patients in the < 35 group had an OS of 66.2% (P < 0.05). Further, the DSM rate was 31.4% within the >= 65 group compared with 29.6% within the < 35 group (P < 0.05). In the multivariate analysis, age, sex, race, grade, stage, location, T, N and M were significantly associated with OS and DSM. Conclusions: The older patients diagnosed with CRC were at significantly greater risk of OS and DSM. In addition, the younger patients were more likely to diagnose liver metastasis than the older, whereas the older cases were less likely to appeared lung metastases compared to the younger.