Yonago Acta medica 1996;39:33-38

Colorectal cancer in the Young and and the Elderly, with Special Reference to the Relative Survival Rate after Surgery

Masato Makino, Kazuo Kurayoshi, Kazuyoshi Hoshino, Osamu Kimura and Nobuaki Kaibara

First Department of Surgery, Faculty of Medicine, Tottori University, Yonago 683, Japan

The aim of this study was to clarify the differences of between colorectal cancers in young and elderly patients, and to compare the results of surgical intervention in these two groups using the relative survival rate. A total of 912 patients with colorectal cancer were reviewed retrospectively for the years between 1941 and 1991. The patients were divided by age as follows: the young (n=36, under 40 years old); the elderly (n=54, 80 and over 80 years old), and the mature (n=288, 60 to 69 years old, as a control group because this was the most frequent age of the patients). The overall 5-year relative survival rates were similar in all three groups: 43% in the young, 54% in the elderly, and 59% in the mature. However, the 5-year survival rate of the young in curatively resected cases (84%) was significantly higher than that of the elderly (53%; P < 0.01), being intermediate in the mature group (73%). There was no significant difference among the three groups in the male to female ratio, in the location of tumor, or in Dukes' staging in resected cases. Differences were found in the percentage of unresected cases (22% in the young vs. 5.6% in the elderly, P < 0.05) and the incidence of poorly differentiated adenocarcinoma (35.6% in the young vs. 5.9% in the mature group, P <0.01). The prognosis of young patients with colorectal cancer was not bad if potentially curative resection was performed. Early detection and curative resection of the tumor is clearly important if we are to improve the overall survival rate of young patients. The prognosis for the elderly patients was not good, even when we considered the relative survival rate, taking account of the other cause of death.

Key words: colorectal carcinoma; elderly; relative survival rate; sixties; young