Surgical resection and survival outcomes in metastatic young adult colorectal cancer patients. (16th June 2021)

• Record Type: Journal Article
• Authors: Arhin, Nina D.; Shen, Chan; Bailey, Christina E.; Matsuoka, Lea K.; Hawkins, Alexander T.; Holowatyj, Andreana N.; Ciombor, Kristen K.; Hopkins, Michael B.; Geiger, Timothy M.; Kam, Audrey E.; Roth, Marc T.; Lebeck Lee, Cody M.; Lapelusa, Michael; Dasari, Arvind; Eng, Cathy
• Is Part Of: Cancer medicine. Volume 10:Number 13(2021)
• Page Start: 4269
• Page End: 4281
• Publication Date: 2021-06-16
• Subjects: cancer -- colorectal -- overall survival -- surgery -- young adult; 616.994005
• DOI: 10.1002/cam4.3940
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: Background: The incidence of colorectal cancer in adults younger than age 50 has increased with rates expected to continue to increase over the next decade. The objective of this study is to examine the survival benefit of surgical resection (primary and/or metastatic) versus palliative therapy in this patient population. Methods: We identified 6708 young adults aged 18–45 years diagnosed with metastatic colorectal cancer (mCRC) from 2004 to 2015 from the SEER database. Overall survival (OS) was analyzed using Kaplan–Meier estimation, log rank test, and multivariate Cox proportional hazards model. Results: Sixty‐three percent of patients in our study underwent primary tumor resection (PTR), with 40% undergoing PTR alone and 23% undergoing both resection of primary disease and metastasectomy. The median OS for patients who underwent both PTR and metastasectomy was 36 months, compared to 13 months for those who did not receive any surgical intervention. The multivariate analysis showed significant OS benefit of receiving both PTR and metastasectomy (HR 0.34, 95% CI: 0.31–0.37, p < 0.001) compared to palliative therapy. Undergoing PTR only and metastasectomy only were also associated with improved OS (HR 0.46, 95% CI: 0.43–0.49, p < 0.001 and HR 0.64, 95% CI: 0.55–0.76, p < 0.001, respectively). Conclusion: This is the largest observational study to evaluate survival outcomes in young‐onset mCRC patients and the role of surgical intervention of the primary and/or metastatic site. Our study provides evidence of statistically significant increase in OS for young mCRC patients who undergo surgical intervention of the primary and/or metastatic site. Abstract : The incidence of colorectal cancer in adults younger than age 50 has increased with rates expected to continue to increase over the next decade. The objective of this study is to examine the survival benefit of surgical resection (primary and/or metastatic) vs palliative therapy in this patient population. Our study provides evidence of statistically significant increase in OS for young mCRC patients who undergo surgical intervention of the primary and/or metastatic site.