Younger patients with colorectal cancer may have better long-term survival after surgery: a retrospective study based on propensity score matching analysis

Abstract Background The relationship between postoperative long-term prognosis and age in colorectal cancer patients remains controversial. The purpose of this study based on a Chinese CRC cohort is to determine the disparity in long-term survival outcomes between younger and older colorectal cancer (CRC) patients after surgery using a propensity score matching (PSM). Methods Data for this study was derived from the CRC cohort of the Database from Colorectal Cancer (DACCA) at West China Hospital of Sichuan University from January 2007 to September 2022. The long‑term prognoses were compared between younger and older groups. Results A total of 2374 CRC patients were evaluated in this study, including 1039 older patients and 1335 younger ones. After 1:1 ratio PSM, each group contained 784 CRC patients. There was no significant difference in baseline information after PSM ( p < 0.05). Multivariate analysis showed that younger age was an independent predictor of better overall survival (OS) ( p < 0.001, HR = 1.750, 95% CI = 1.407–2.177) and disease-specific survival (DSS) ( p < 0.001, HR = 1.718, 95% CI = 1.369–2.157). In terms of different tumor pathological stages after PSM, in comparison to older group, younger group had better OS in stage II ( p < 0.001), stage III ( p = 0.0085), and stage IV ( p = 0.0014) and better DSS in stage II ( p = 0.0035), stage III ( p = 0.0081), and stage IV ( p < 0.001). Conclusion Younger CRC patients have better prognosis than older CRC patients after surgery, especially, and have better OS and DSS in stages II, III, and IV CRC. Younger CRC patient may gain greater benefit from CRC resection and combined therapy. As for the cut-off age, it may be determined by a specific model suitable for local patients.