Prognostic Factors for Patients Under 45 Undergoing Surgery for Colorectal Liver Metastases: A SEER Population‐Based Study

BACKGROUND AND OBJECTIVES: Colorectal cancer (CRC) has been on the rise in adults younger than 50. Surgical resection is a potentially curative treatment option for patients with colorectal liver metastases (CRLM). The aim of this study was to describe patient and tumor characteristics associated with disease-specific survival in young patients (< 45 years) versus older patients (≥ 45 years) with isolated CRLM. METHODS: The SEER database was queried for patients with CRLM who underwent colon and liver resection from 2010 to 2021. Patients under age 20, with metastases beyond the liver, or who had not had surgery for liver metastases were excluded. Cox regression was used to analyze demographic factors, tumor characteristics, and treatment order. RESULTS: The study group consisted of 2222 patients, with 299 patients less than 45 years old, and 1923 patients at least 45 years old. Higher nodal burden was associated with worse survival in both groups. Elevated CEA was associated with worse survival only in older patients. Younger patients experienced initial longer disease-specific survival. CONCLUSIONS: Typical prognostic factors for older patients do not have the same impact on disease-specific survival for younger patients. Further study may help describe patient and tumor selection for surgical resection of colorectal liver metastases in young patients.