PROGNOSTIC FACTORS AND SURVIVAL OF PATIENTS AGED LESS-THAN 45 YEARS WITH COLORECTAL-CANCER

Colorectal cancers in 92 patients aged 45 years and under presenting o ver a 20-year period (1970-1990) were studied. A delay of more than 4 months in presentation was seen in 27 per cent of patients. All underw ent surgery, 14 per cent emergency and 86 per cent elective, and follo w-up was available for 91 patients. Overall, 14 per cent of patients h ad Dukes A rumours, 32 per cent Dukes B, 36 per cent Dukes C and 18 pe r cent Dukes 'D'. Local recurrence occurred in eight (9 per cent) of t he 92 patients and overall 5- and 10-year survival rates were 61 and 5 9 per cent. Multivariate analysis identified independent risk factors for local recurrence to be mucinous carcinoma (relative effect 4.9) an d the presence of intramural vascular invasion by tumour (relative eff ect 9.4). For overall survival, independent risk factors were involvem ent of the regional lymph nodes by tumour (relative effect 2.0), extra mural invasion by tumour cells (relative effect 3.0), tumour size (rel ative effect 1.8) and the presence of metastatic disease at initial di agnosis (relative effect 3.7).