Relationship between Age and The Histopathological Features to Chemotherapy Response in Colorectal Cancer Patients: A Prospective Observational Study

Lukman, Kiki; Gunawan, Gun Gun; Rudiman, Reno; Sribudiani, Yunia; Hasibuan, Lisa Y.; Dewayani, Birgitta M.; Nugraha, Prapanca; Primastari, Etis

doi:10.1055/s-0043-1776890

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Original Article • J Coloproctol 43 (4) • Dec 2023 • https://doi.org/10.1055/s-0043-1776890 copy

Relationship between Age and The Histopathological Features to Chemotherapy Response in Colorectal Cancer Patients: A Prospective Observational Study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Chemotherapy response in early age-onset colorectal cancer patients is still controversial, and the results of chemotherapy response are unknown. Therefore, the purpose of this study is to determine the relationship between the age of colorectal cancer patients and histopathological features and chemotherapy response.

Methods

This is a prospective observational study. The subjects in this study were colorectal cancer patients in the Digestive Surgery division at Tertiary Hospital in West Java from September 2021 to September 2022.

Results

There were 86 subjects who underwent chemotherapy in accordance with the inclusion and exclusion criteria. Consisting of 39 patients of early age onset and 44 female patients. The most common histopathological feature in early age onset (EAO) and late age onset (LAO) was adenocarcinoma (25% and 46%, respectively). Stage III colorectal cancer affected 38 patients, while stage IV affected 48 patients. There was a significant relationship between early age onset and late age onset with histological features (p < 0.001). The patients with the highest chemotherapy response had stable diseases in EAO (17 patients) and LAO (20 patients). There was no statistically significant relationship between age, histological features, and stage of colorectal cancer and chemotherapy response (p > 0.05). The results of the ordinal logistic regression test showed no systematic relationship between chemotherapy response and age, histopathological features, gender, or cancer stage (p > 0.05).

Conclusion

There was no association between age and histopathologic features with chemotherapy response and there is no difference in chemotherapy response between early and late age onset.

Keywords
early-onset; chemotherapy; histopathological features; late-onset

HIGHLIGHTS

- Age is a risk factor for colorectal cancer and increases sharply after age 50

- Adenoma carcinoma is the most prevalent type of colorectal cancer.

- Increasing prevalence of patients with early age-onset colorectal cancer.

Variable	N	%
Sex
Male Female	42 44	48,8 51.2
Age (years old)^a a Mean ± SD.	50.73 ± 13.37
Early age onset Late age onset	39 47	45,3 54.7
Family History
With family history Without family history	11 75	12.7% 87.3%
Histopathological feature
Adenocarcinoma Mucinous adenocarcinoma Signet ring cell carcinoma Other histopathology type	71 6 7 2	82.6 7.0 8.1 2.3
Levels of differentiation
Well differentiated Moderate differentiated Poor differentiated	38 20 4	59.4 31.3 6.3
Chemotherapy response
Complete response Partial response Stable diseases Progressive diseases	14 21 37 14	16.3 24.4 43.0 16.3

Variable	Early Age Onset (%)	Late Age Onset (%)
Histopathological Features
Adenocarcinoma Mucinous adenocarcinoma Signet ring cell carcinoma Other histopathology type	25 (35,2) 6 (100,0) 7 (100,0) 1 (50,0)	46 (64,8) 0 (0,0) 0 0,0) 1 (50,0)
Chemotherapy response
Complete response Partial response Stable diseases Progressive diseases	6 (42,9) 9 (42,9) 17 (45,9) 7 (50,0)	8 (57,1) 12 (57,1) 20 (54,1) 7 (50,0)

Variable	Chemotherapy response				Total
Variable	Complete response	Partial response	Stable diseases	Progressive diseases	Total
Histopathological Features by Stage
Adenocarcinoma
Stage 3 Stage 4	6 5	8 9	11 21	5 6	30 41
Mucinous adenocarcinoma
Stage 3 Stage 4	1 0	0 1	0 2	1 1	2 4
Signet ring cell carcinoma
Stage 3 Stage 4	2 0	1 0	2 1	0 1	5 2
Other Histopathology Type
Stage 3 Stage 4	0 0	1 1	0 0	0 0	1 1
Total
Stage 3 Stage 4	9 5	10 11	13 24	6 8	38 48

Variable	Histopathological Features		P Value	CC
Variable	Adenocarcinoma	Other type	P Value	CC
Age
Early Age Onset	25	14	<0,001	0,405
Late Age Onset	46	1	<0,001	0,405

Variable	Chemotherapy Response				P Value	CC
Variable	Complete response	Partial response	Stable diseases	Progressive diseases	P Value	CC
Age
Early Age Onset	6	9	17	7	0,975	0,050
Late Age Onset	8	12	20	7	0,975	0,050
Histopathological Features
Adenocarcinoma	11	17	32	11	1,000	0,302
Others type	3	4	5	3	1,000	0,302
Stage of Cancer
III	9	7	15	7	0,313	0,201
IV	5	14	21	7	0,313	0,201

	OR	P
Model Fitting Information (Chi-Square)		0.592
Goodness-of-Fit (Pearson)		0.278
Test of Parallel Lines		0.496
Partial Analysis
Onset
Early Age Onset	1.437	0.421
Late Age Onset	-	-
Histopathology
Mucinous Adenocarcinoma	3.458	0.358
Adenocarcinoma	5.593	0.254
Carcinoma cell Signet Ring	2.603	0.517
Other Histopathology Type	-	-
Sex
Female	1.892	0.123
Male	-	-
Stage
Stage III	0.937	0.874
Stage IV	-	-

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E-mail: sbcp@sbcp.org.br

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[1] Address for correspondence Kiki Lukman, Doctor of Philosophy/Gastrointestinal Surgeon, Jalan Pasteur No. 38, Pasteur, Kecamatan Sukajadi, Kota Bandung, Jawa Barat, Indonesia 40161 (e-mail: kiki.lukman@unpad.ac.id).