OBJECTIVETo compare the clinicopathological features and prognosis between patients under 40 years old (young group) and patients over 65 years old (old group) with rectal carcinoma.

METHODSThe data of 138 young rectal cancer patients and 163 old patients, treated in our hospital from January 1990 to January 2000, were analyzed retrospectively by SPSS 11.5 software. Survival was estimated by the Kaplan-Meier method and comparison by the log-rank test. Cox regression was used in multivariate analysis.

RESULTSStage III patients accounted for 53.6% (74/138) in young group, which was significantly higher as compared with 34.3% (55/163) in old group (P=0.001). The young group had significantly worse histologic grade with 28.2% of poorly differentiated tumors compared with 10.4% in the old group (P<0.001). The overall 5-year survival rates were 50.4% and 64.1% in young and old group respectively (P<0.05). However, the 5-year survival rates of the young group and old group with same TNM stage were similar. Cox regression showed that lymph node metastasis and T stage were independent prognostic factors.

CONCLUSIONSAs compared to the old patients, advanced stage and poorly differentiated carcinoma are more common in young patients with rectal cancer. However, no significant difference of survival rate is found between the young and the old patients with same stage. Early examination and treatment are crucial to improve the survival rate of rectal cancer.