Node Yield and Node Involvement in Young Colon Cancer Patients: Is There a Difference in Cancer Survival Based on Age?

Background: The effect on cancer-specific survival (CSS) from the number of resected nodes (node yield) and the number of nodes involved with colon cancer has not been studied with respect to age. Patient and Methods: Data from 1992 to 2006 from the Surveillance, Epidemiology and End Results (SEER) registry were analyzed for colon cancer patients undergoing curative resection, comparing younger (<40; n=2,642) and older (≥40; n=138,769) patients. Results: The mean number of positive nodes and mean node yield was higher for the younger group. Younger patients were more likely to have metastatic disease and to have a nodal yield of ≥12 nodes, and were less likely to have node-negative colon cancers (all p<0.0001). Younger age was associated with a lower risk of death from colon cancer (HR=0.65; p<0.0001). No CSS effect was noted with the interaction of age with either node yield or node involvement. Node yield <12 created a higher risk of cancer-specific death (HR=1.22; p<0.0001) regardless of stage. KM plots by stage demonstrated a CSS advantage (p<0.0001) for younger patients. Conclusions: Younger patients with colon cancers do not have a worse CSS simply because of their young age, so long as proper oncologic surgical principles are adhered to.