Table 3.
Previous studies of prognosis and treatment of early-onset colorectal cancer.
| Ref No. |
Authors (year) |
Country | No. of cases (diagnosed age) |
Prognosis / treatment |
|---|---|---|---|---|
| 77 | O'Connell et al. (2004) | United States | 1,334 EOCRC (20-40) vs 46,457 LOCRC (60-80) | The 5- year CRC-related survival of young CRC vs older CRC patients was 93% vs 95% (p, NS) for stage I, 89% vs 83% (p = 0.01) for stage II, and 59% vs 57% (p, NS) for stage III: 18% vs 6% (p < 0.001) for stage IV. |
| 75 | Quah et al. (2007) | United States | 68 EOCRC (≤40) vs 1,259 older CRC (>40) in Stage I-III | The 5-year CRC-related survival of young vs older CRC patients was 86% vs 87% (p, NS). The 5-year OS was higher in the EOCRC (84% vs 73%, p = 0.001). Young patients were also more likely to receive adjuvant chemotherapy, especially in the stage II: 39% vs 14%, (p = 0.003). |
| 71 | McMillan et al. (2009) | United Kingdom | 99 EOCRC (<45) vs 1,978 older CRC (≥45) | Compared with young CRC patients aged <45, older CRC patients aged ≥45 had no significant difference in their hazard ratios for cancer-specific survival. |
| 64 | Sultan et al. (2010) | Jordan | 159 EOCRC (4-20) in 550,622 CRC | SEER: The 5-year relative survival of young CRC vs older CRC were 40% vs 60% (p < 0.001). The 10-year relative survival, 31% vs 54%. |
| 67 | Blanke et al. (2011) | Multiple countries* | 793 EOCRC vs 5,491 LOCRC in stage IV | Results from phase III trials. Response rate and OS were similar in CRC patients aged <50 and ≥50 in stage IV; PFS was minimally worse in the younger cohort (6.0 v 7.5 months; p = 0.02). |
| 78 | Hubbard et al. (2012) | United States | 5,817 EOCRC vs 27,757 LOCRC | Younger patients aged <40 or <50 years with stage II and III colon cancer had longer OS and DFS than older patients. Younger patients (aged <40 or <50) with stage II and III colon cancer derive similar benefit from adjuvant therapy as older patients. |
| 73 | Schellerer et al. (2012) | Germany | 244 EOCRC vs 1,718 LOCRC | The 5- year CRC-related survival of EOCRC vs LOCRC patients was 89% vs 80% (p = 0.01) for M0 rectal cancer, 21% vs 12% (p = 0.06) for M0 rectal cancer, 84% vs 89% (p, NS) for M1 colon cancer, 13% vs 15% (p, NS) for M1 colon cancer. |
| 70 | Yang et al. (2012) | China | 530 EOCRC (≤44) vs. 2,626 CRC (>44) | Compared to older patients, young patients received chemotherapy and died of cancer related causes. OS, DFS and cancer-specific survival of younger patients were comparable to older patients. |
| 63 | Lieu et al. (2014) | United States | 3,051 EOCRC in 20,023 stage IV CRC | Relative to patients of middle age CRC, young CRC patients had 19% (95% CI, 7-33%) increased risk of death and 22% (95% CI, 10-35%) increased risk of progression. The age effect did not differ by sites of metastatic disease, year of enrollment, types of therapy received, or biomarker mutational status. |
| 32 | Kneuertz et al. (2015) | United States | 13,102 EOCRC (18-49) vs 37,007 LOCRC (65-75) | The 5-year CRC-related survival of young vs older CRC patients was 91% vs 90% for stage II overall, 95% vs 95% for stage II low risk, and 88% vs 86% for stage II high risk. Almost 6% of the patients with young-onset stage I received adjuvant chemotherapy. Adjuvant chemotherapy was administered for 51% of young patients and 9% of older patients. |
| 81 | Orsini et al. (2015) | Netherlands | 1,102 EOCRC (≤40) vs 35,954 CRC (41-70) | Young age was a prognostic factor for better survival in stage I-III patients. Adjuvant chemotherapy was more often given to young CRC patients (24% vs 14%, p <0.001). Adjuvant chemotherapy in young stage III and pN1 patients was associated with improved survival. |
| 74 | Wang et al. (2015) | Sweden and United States | 43,821 EOCRC vs 466,113 LOCRC | SEER: The 5-year relative survival of young CRC vs older CRC were 67% vs 61% (p <0.001) in SEER database; 75% vs 63% (p = 0.25) in Linköping Cancer database. |
| 80 | Abdelsattar et al. (2016) | United States | 37,847 EOCRC vs 220,177 LOCRC (50-75) | SEER: CRC patients with distant metastasis were more likely to receive surgical therapy for their primary tumors in younger age group (adjusted probability: 72% vs 63%; p < 0.001), and radiation therapy was more likely in younger CRC patients (adjusted probability: 53% vs 48%; p <0.001). |
| 76 | Boyce et al. (2016) | Australia | 2,001 EOCRC vs 30,177 LOCRC | 5-year cancer-specific survival was greater for patients with EOCRC than for LOCRC (69% vs 66%) (p <0.001). |
| 29 | Holowatyj et al. (2016) | United States | 28,145 EOCRC | SEER: The 5-year OS was 55% among non-Hispanic blacks, 68% among non-Hispanic whites, and 63% among Hispanic individuals (p <0.001). |
| 65 | Kim et al. (2016) | Korea | 693 EOCRC (≤45) vs 1,823 LOCRC (56-65) | The 5-year cancer-specific survival rate was 81% in the young group and 88% in the older group (p <0.001). No significant difference in OS for each stage. |
| 66 | Chou et al. (2017) | Taiwan | 3,395 EOCRC (≤40) in 61,789 CRC | Young CRC (≤40) had poorer OS and cancer-specific survival compared to older CRC (41–50 and 51–60) groups, although this trend was reversed in the 71–80 and >80 age groups. |
| 72 | Manjelievskaia et al. (2017) | United States | 671 EOCRC, 1,599 LOCRC (50-64), and 873 LOCRC (≥65) | EOCRC and middle-aged CRC patients were more likely to receive multiagent chemotherapy than older patients (EOCRC: OR, 2.5; 95% CI, 1.4-4.3 and middle-aged CRC: OR, 2.7; 95% CI, 1.7-4.2). Among patients who received surgery and postoperative systemic chemotherapy, no significant differences were observed in survival among age groups. |
| 68 | Pokharkar et al. (2017) | India | 351 EOCRC (≤45) vs 427 CRC (>45) | No statistically significant difference was found in OS between young and old CRC patients. |
| 69 | Rho et al. (2017) | Multiple countries** | 224 EOCRC (≤44) vs 274 CRC (>44) | The mortality analysis showed no significant differences between the two groups. The longitudinal treatment patterns for both groups were similar but more biological therapy was used for young CRC. |
| 79 | Kolarich et al. (2018) | United States | 9,126 EOCRC vs 33,980 LOCRC (50-75) | The receiving rates of radiation therapy were 42 % in stage I EOCRC patients and 32% in LOCRC patients, respectively (p < 0.001); the receiving rates of chemoradiation therapy were 94% in stage II and III EOCRC patients and 88% in stage II and III LOCRC patients. |
| 55 | Rodriguez et al. (2018) | Canada | 107 EOCRC (≤40) vs. 5,364 LOCRC (>60) | Compared with patients aged > 60 years, adjuvant chemotherapy was delivered more often to younger CRC patients aged ≤40 years for stage II (50% vs 13%; p <0.001) and stage III (> 92% vs 57%; p <0.001), respectively. OS and cancer-specific survival were superior for the patients aged ≤40 years compared with the patients aged >60 years. |
Studies with 100 or fewer cases or cases overlapping with another study (eg, SEER database) may not be listed, except for some studies.
*
France, Germany, United Kingdom, and United States.
**
Bulgaria, Canada, Czech Republic, Georgia, Ireland, and Italy.
Abbreviations: CI, confidence interval; CRC, colorectal cancer; DFS, disease-free survival; EOCRC, early-onset colorectal cancer; LOCRC, later-onset colorectal cancer; NS, not significant; OR, odds ratio; OS, overall survival; PFS, progression-free survival; SEER, Surveillance, Epidemiology, and End Results.