Impact of age on clinical and pathological features as well as outcome in Egyptian patients with colorectal cancer (CRC).

Abstract

600 Background: The incidence of early onset CRC is rising. Little is known about the clinicopathological differences between younger and older Egyptian (EGY) adults with CRC. Herein we explore these differences. Methods: A retrospective review of younger EGY adult (YA; ≤ 46 years) and older EGY adult (OA; > 65 years) patients (pts) with CRC was performed. T and Fisher’s exact tests were used for comparative analyses. Kaplan-Meier methodology estimated survival. Results: In total, 997 EGY pts with CRC were studied, including 443 YA (median age 35 years; range 15-46) and 153 OA pts (median 70 years range 65-84).There were no statistically significant differences with respect to gender, degree of tumor differentiation, extracolonic extension, stage at presentation, or patterns of metastasis between the two groups. YA pts had more rectal primaries compared with OA pts (49% vs. 31%, p < 0.001), whereas older pts had more colon primaries (69% vs. 51%, p < 0.001). Additionally YA pts had more left-sided tumors (78% vs. 62%, p < 0.001) compared with OA pts, whereas older pts had more right-sided tumors (32% vs. 17%, p < 0.001). YA pts were more likely to have mucin-producing tumors (40% vs. 23%, p = 0.003). Although there were no differences in the proportion of pts presenting with metastatic disease (28% [YA] vs. 32% [OA], p = 0.615), or the pattern of metastasis to the liver, lung, or peritoneum (40% vs. 50%, p = 0.288; 5% vs. 6%, p = 1.00, 16% vs. 17%, p = 1.00), YA were more likely to have CRC-related lymph node (LN) involvement (mean: 3.2 vs. 1.6, p = 0.006). There were no differences in PFS (Median: 12 months for YA vs. 13 months for OA) or OS (median: 76 months for YA vs. not reached for OA) between the two groups. However male YA pts had a better OS that female pts (median OS not reached in males, 72 months in females). Conclusions: Significant differences were evident between YA and OA pts with CRC, notably locations of primary tumors. Male had improved outcome compared to female YA patients. Additional evaluation of the molecular features of CRC in young and older patients in Egypt is warranted.