Chan, K.K.Dassanayake, B.Deen, R.Wickramarachchi, R.E.Kumarage, S.K.Samita, S.Deen, K.I.2022-01-142022-01-142010World Journal of Surgical Oncology. 2010; 8:821477-7819 (Electronic)http://repository.kln.ac.lk/handle/123456789/24343Indexed in MEDLINE; ScopusOBJECTIVES: This study compares clinico-pathological features in young (<40 years) and older patients (>50 years) with colorectal cancer, survival in the young and the influence of pre-operative clinical and histological factors on survival. MATERIALS AND METHODS: A twelve-year prospective database of colorectal cancer was analysed. Fifty-three young patients were compared with forty-seven consecutive older patients over fifty years old. An analysis of survival was undertaken in young patients using Kaplan Meier graphs, non-parametric methods, Cox's Proportional Hazard Ratios and Weibull Hazard models. RESULTS: Young patients comprised 13.4 percent of 397 with colorectal cancer. Duration of symptoms and presentation in the young was similar to older patients (median, range; young patients; 6 months, 2 weeks to 2 years, older patients; 4 months, 4 weeks to 3 years, p > 0.05). In both groups, the majority presented without bowel obstruction (young--81%, older--94%). Cancer proximal to the splenic flexure was present more in young than in older patients. Synchronous cancers were found exclusively in the young. Mucinous tumours were seen in 16% of young and 4% of older patients (p < 0.05). Ninety-four percent of young cancer deaths were within 20 months of operation. At median follow up of 50 months in the young, overall survival was 70% and disease free survival 66%. American Joint Committee on Cancer (AJCC) stage 4 and use of pre-operative chemoradiation in rectal cancer was associated with poor survival in the young. CONCLUSION: If patients, who are less than 40 years old with colorectal cancer, survive twenty months after operation, the prognosis improves and their survival becomes predictable.enColorectal NeoplasmsColorectal Neoplasms-diagnosisColorectal Neoplasms-surgeryColorectal Neoplasms-mortalityColectomyNeoplasm Staging-methodsPostoperative PeriodFollow-Up StudiesProspective StudiesSri Lanka-epidemiologyRisk FactorsSurvival Rate-trendsArticle