Abstract
The incidence of colorectal cancer (CRC) in young patients (≤50 years of age) appears to be increasing. However, their clinicopathological characteristics and survival are controversial. Likewise, the biomarkers are unclear. We used the West China (2008-2013, China), Surveillance, Epidemiology, and End Results program (1973-2011, United States) and Linköping Cancer (1972-2009, Sweden) databases to analyse clinicopathological characteristics, survival and multiple biomarkers of young CRC patients. A total of 509,934 CRC patients were included from the three databases. The young CRC patients tended to have more distal location tumours, fewer tumour numbers, later stage, more mucinous carcinoma and poorer differentiation. The cancer-specific survival (CSS) of young patients was significantly better. The PRL (HR = 12.341, 95% CI = 1.615-94.276, P = 0.010), RBM3 (HR = 0.093, 95% CI = 0.012-0.712, P = 0.018), Wrap53 (HR = 1.952, 95% CI = 0.452-6.342, P = 0.031), p53 (HR = 5.549, 95% CI = 1.176-26.178, P = 0.045) and DNA status (HR = 17.602, 95% CI = 2.551-121.448, P = 0.001) were associated with CSS of the young patients. In conclusion, this study suggests that young CRC patients present advanced tumours and more malignant pathological features, while they have a better prognosis. The PRL, RBM3, Wrap53, p53 and DNA status are potential prognostic biomarkers for the young CRC patients.
Highlights
IntroductionBecause of the likely biases associated with single-institution experiences or limit cohort sizes, the data vary markedly
We have identified a total of 509,934 eligible patients with Colorectal cancer (CRC) in three databases (n = 5,918 in West China (WC), n = 5 03,002 in SEER and n = 1,014 in Linköping Cancer (LC))
The integrated analysis of multiple biomarkers and prognostic factors was performed in young CRC patients compared with elderly patients
Summary
Because of the likely biases associated with single-institution experiences or limit cohort sizes, the data vary markedly. Most afflicted individuals lack any identifiable risk factor for their development or potential biomarker for prognosis prediction. The mechanisms underlying the apparent increase in CRC among young patients are poorly understood. We analysed clinicopathological characteristics, prognostic factors and survival of young CRC patients from the West China (WC), Surveillance, Epidemiology, and End Results program (SEER) and Linköping Cancer (LC) databases. We assessed the molecular features and the prognostic value of these biomarkers in young CRC patients in LC database
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