Original Article
Gender differences in clinicopathological characteristics and prognosis of rectal cancer patients under 50 years old
Tian Mingwei, Yang Yun, Feng Zhewen, Gu Xiaozhe, Li Dongming, Li Jun, Yao Hongwei, Bai Zhigang, Yang Yingchi, Zhang Zhongtao
Published 2022-11-15
Cite as Int J Surg, 2022, 49(11): 739-745,C1. DOI: 10.3760/cma.j.cn115396-20221022-00348
Abstract
ObjectiveTo explore whether there are gender differences in clinical and pathological characteristics and prognosis of young patients with rectal cancer (under 50 years old), and to analyze the risk factors affecting the prognosis of young patients with rectal cancer.
MethodsThe medical records of 85 young rectal cancer patients admitted to Beijing Friendship Hospital Affiliated to Capital Medical University from January 2015 to December 2020 were retrospectively collected. According to gender, they were divided into male group (n=50) and female group (n=35). The age was (43.67±5.50) years old, ranging from 26 to 50 years old. Primary outcome measures were sex, disease-free survival, and overall survival. Secondary outcomes were family history, body mass index (BMI), clinical stage, anemia, whether the female patient was menopausal, whether the female patient took oral estrogen, the location of the primary lesion, whether neoadjuvant therapy was performed, pathological stage, whether accompanied with vascular nerve invasion, and whether postoperative adjuvant therapy was performed. R4.0.2 software was used for statistical analysis. The measurement data with normal distribution in the collected data were expressed as mean±standard deviation (
±s), and the comparison between groups was analyzed by t test. Count data were expressed as constituent ratio, and analyzed using the chi-square test or Fisher′s exact test. The survival curve was drawn by Kaplan-Meier method, and the difference in survival rate was tested by Log-rank test. Factors with statistical significance in univariate analysis were included in COX proportional regression model for multivariate analysis to screen independent risk factors affecting overall survival.
ResultsCompared with male patients, a higher proportion of young female patients with rectal cancer were diagnosed with anemia before surgery (42.9% vs 22.0%, P=0.040). The 1-year, 3-year and 5-year overall survival rates were 94.3%, 80.0% and 68.6% in young female patients, and 98.0%, 90.0% and 90.0% in young male patients, respectively. The median disease-free surival was 31.6 months for women and 34.4 months for men. Multivariate analysis showed that female(HR=3.799, 95%CI: 1.312-11.002, P=0.014)and BMI(HR=0.846, 95%CI: 0.724-0.989, P=0.036)were independent risk factors affecting the prognosis of young patients with rectal cancer.
ConclusionsYoung female patients have a worse prognosis than male patients. Female and BMI are independent risk factors for the prognosis of young rectal cancer patients, and gender should be the key research object of observation in young rectal cancer patients.
Key words:
Sex factors; Rectal neoplasms; Age of onset; Anemia
Contributor Information
Tian Mingwei
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Yang Yun
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Feng Zhewen
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Gu Xiaozhe
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Li Dongming
Department of Gastric and Colorectal Surgery, the First Hospital of Jilin University, Changchun 130021, China
Li Jun
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Yao Hongwei
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Bai Zhigang
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Yang Yingchi
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Zhang Zhongtao
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
±s)表示，组间比较采用t检验；计数资料采用例数和百分率(%)表示，组间比较采用χ2检验或Fisher精确概率法。采用Kaplan-Meier法绘制生存曲线、Log-rank检验生存率差异。将单因素分析中有统计学意义的因素纳入COX比例风险回归模型进行多因素分析以筛选影响总生存期的独立危险因素。
