Clinicopathological patterns and survival outcomes of colorectal cancer among young adults in Malaysia: An institutional cohort study

Wong, Sui-Weng and Ling, Dao-Yao and Yeow, Ri-Qi and Chong, Ro-Wan and Aziz, Mohamed Rezal Abdul and Aziz, Nora Abdul and Poh, Keat-Seong and Roslani, April Camilla (2021) Clinicopathological patterns and survival outcomes of colorectal cancer among young adults in Malaysia: An institutional cohort study. Singapore Medical Journal, 62 (12). pp. 636-641. ISSN 0037-5675, DOI https://doi.org/10.11622/smedj.2021051.

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Abstract

This study aimed to investigate the clinicopathological patterns and survival outcomes of patients with young-onset colorectal cancer (CRC) in Malaysia. METHODS A total of 206 patients with young-onset CRC (age < 50 years at diagnosis) and 1,715 patients with late-onset CRC (age >= 50 years at diagnosis) diagnosed during 2002-2016 were included. The clinicopathological characteristics of patients with young-onset CRC were compared with those of patients with late-onset CRC during 2009-2013. Kaplan-Meier survival analysis was performed to determine the overall survival (OS) and disease-specific survival (DSS) in these patients. RESULTS The overall proportion of young-onset CRC was 10.7%. The mean age for young-onset CRC was 39.5 +/- 7.4 years, with a male-to-female ratio of 1.2:1. There were more Malay patients with young-onset CRC than late-onset CRC (44.0% vs. 19.9%, p = 0.004). Most CRCs were diagnosed at an advanced stage in both groups. However, young-onset CRC showed more aggressive tumour characteristics, such as poorer differentiation and mucinous subtype. Despite such differences, the OS and DSS in both groups were similar (five-year OS for young-onset CRC vs. late-onset CRC: 44.2% vs. 49.0%, p = 0.40; five-year DSS for young-onset CRC vs. late-onset CRC: 48.8% vs. 57.6%, p = 0.53; mean survival of young-onset CRC vs. late-onset CRC: 4.9 years vs. 5.4 years, p = 0.15). Advanced stage at diagnosis and the treatment modality used were independent prognostic factors. CONCLUSION The unique ethnic and histological differences between patients with young-and late-onset CRC suggest that young-onset CRC may represent a distinct entity. However, despite such differences, both groups were equivalent.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Colorectal cancer;Malaysia;Prognosis;Survival rates;Young adults
Subjects: R Medicine
R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RD Surgery
Divisions: Faculty of Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 17 Oct 2022 02:42
Last Modified: 17 Oct 2022 02:42
URI: http://eprints.um.edu.my/id/eprint/35298

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