Short- and Long-term Outcomes After Curative Surgery for Rectal Cancer in Patients Under the Age of Fourty Years: A Stage Based Case-match Analysis

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İstanbul Medical Journal, vol.21, no.2, pp.126-131, 2020 (ESCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: 21 Issue: 2
  • Publication Date: 2020
  • Doi Number: 10.4274/imj.galenos.2020.33339
  • Journal Name: İstanbul Medical Journal
  • Journal Indexes: Emerging Sources Citation Index (ESCI), TR DİZİN (ULAKBİM)
  • Page Numbers: pp.126-131
  • Keywords: Rectal cancer, young, survival, outcome
  • Istanbul Medipol University Affiliated: Yes


Introduction: The aim of the study is to compare the short andlong-term outcomes after curative surgery for rectal cancer inpatients under the age of 40 years and over the age of 50 years.Methods: A total of 46 patients with rectal cancer were retrievedfrom a prospectively designed database after the exclusion ofstage 4 cases (<40 group). A case-match group (1:2) at similarstage was created among patients over 50 years of age (>50group, n=92). Demographics, perioperative information, andoncological and pathological results were compared betweenthe groups. The primary outcome measure was 5 year survival.Results: The numbers of male cases were similar (59% vs 52%,p=0.468) between the groups. There were more patients whoreceived preoperative radiation (98% vs 71%, p<0.001) in <40group related to the location of the tumor and intoleranceto the treatment. The tumors were closer to the dentateline [3 (0-15) cm vs 5 (0-15) cm, p=0.006)] and the rate ofabdominoperineal resection was higher (39% vs 22%, p=0.031)in <40 group. Laparoscopy (72% vs 85%, p=0.069), conversionto open surgery (7% vs 10%), p=0.751), operation time (224±57min vs 210±62 min, p=0.226), intraoperative bleeding [200(10-1300) mL vs 200 (10-1500) mL, p=0.514], requirement ofperioperative transfusion (30% vs 27%, p=0.688), reoperation(2% vs 2%, p=0.999) and 30 day mortality (2% vs 1%, p=0.333)rates, hospitalization period [7 (4-49) vs 7 (2-47) days, p=0.25]were similar. Tumor differentiation was poorer (p=0.046) in<40 group, but other pathological parameters were similarbetween the groups: number of harvested lymph nodes [14(0-53) vs 12 (0-43), p=0172], number of malignant lymphnodes [1 (0-29) vs 1(0-11), p=0.616] and invasion rates [(0.090-0.93) vs 0.07(0-0.82), p=0.762]. Kaplan-Meier analysisrevealed similar 5 year survival rates (63% vs 60%, p=0.052).Conclusion: When similar tumor stages are considered, thesurvival is similar in rectal cancer patients below the age of 40years and over the age of 50 years.