To evaluate patient and tumor factors associated with disease-specific survival in young patients (< 45 years old) with colorectal liver metastases compared to older patients (≥ 45 years).
Approach:
Data Source: The SEER database was queried for patients with colorectal liver metastases who underwent primary colon and liver resection from 2010 to 2021.
Patient Groups: Patients were divided into two groups based on age: < 45 years and ≥ 45 years.
Statistical Analysis: Chi-square test and Mann-Whitney U test were used for comparisons; Kaplan-Meier analysis for survival; Cox proportional hazards regression for prognostic factors.
Key Findings:
Younger patients had a higher proportion of advanced nodal disease (44% N2 vs. 34% N2 in older patients, p < 0.01).
Median overall survival was 61 months for younger patients and 49 months for older patients.
5- and 10-year overall survival rates were higher for younger patients (51.4% (CI 43.5%–58.8%) and 26.5% (CI 18.1%–35.6%)) compared to older patients (41.4% (CI 38.6%–44.2%) and 23.7% (CI 20.8%–26.7%)).
Disease-specific survival was also initially better for younger patients but diminished by 10 years.
In older patients, higher household income and lower nodal disease burden were associated with lower risk of disease-specific death.
Interpretation:
Younger patients with colorectal liver metastases initially show better survival outcomes compared to older patients, but this advantage diminishes over time.
Limitations:
The study is retrospective and relies on SEER database data, which may have inherent biases.
Factors influencing treatment decisions and outcomes may not be fully captured in the database.
Conclusion:
The study emphasizes the importance of tailored prognostic assessments for younger patients with colorectal liver metastases.
