Colorectal cancer in the young: a possible role for immune surveillance?

Alain Fiorot, Anna Pozza, Cesare Ruffolo, Ezio Caratozzolo, Luca Bonariol, Francesco Enrico D’Amico, Luigi Padoan, Francesco Calia di Pinto, Marco Scarpa, Carlo Castoro, Nicolò Bassi, Marco Massani

Research output: Contribution to journalArticle

Abstract

Background: Younger patients with colorectal cancer (CRC) generally have better survival in spite of worse clinical and pathological features. Methods: Twenty-six patients under 50 years operated for primary CRC were enrolled and matched 1:2:2 according to stage, tumor site and gender with 52 patients from 50 to 70 years and 52 patients over 70 years old. Results: Patients under 50 years had a significantly longer overall, cancer specific and disease free survival (p =.001, p =.007 and p =.05, respectively). However, they had more frequently lymphovascular invasion (p =.006) and they more frequently developed metachronous CRC at follow-up (p =.03). Nevertheless, preoperative lymphocytes blood count/white blood count (LBC/WBC) ratio inversely correlated with age at operation (rho = −.21, p =.04) and it predicted CRC recurrence with an accuracy of 70%, p <.001 (threshold value LBC/WBC = 0.21%) and better overall, cancer specific and disease free survival (p <.0001 for all). At multivariate analysis, stage and LBC/WBC ratio resulted independent predictors of disease free survival (p =.0001 and p =.01, respectively). Conclusions: Patients under 50 years had a significantly longer survival with a higher LBC/WBC ratio. These results could suggest a possible role of immunosurveillance in neoplastic control.

Original languageEnglish
Pages (from-to)7-14
Number of pages8
JournalActa Chirurgica Belgica
Volume118
Issue number1
DOIs
Publication statusPublished - Jan 2 2018

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Keywords

  • Colorectal cancer
  • immonosurveillance
  • survival
  • young age

ASJC Scopus subject areas

  • Surgery

Cite this

Fiorot, A., Pozza, A., Ruffolo, C., Caratozzolo, E., Bonariol, L., D’Amico, F. E., Padoan, L., Calia di Pinto, F., Scarpa, M., Castoro, C., Bassi, N., & Massani, M. (2018). Colorectal cancer in the young: a possible role for immune surveillance? Acta Chirurgica Belgica, 118(1), 7-14. https://doi.org/10.1080/00015458.2017.1353233