Poorer prognosis in young female patients with non-metastatic colorectal cancer: a hospital-based analysis of 5,047 patients in China

Figures & data

Table 1 Clinicopathological characteristics of 5,047 non-metastatic colorectal cancer patients

Characteristics	Male, n (%)	Female, n (%)	P-value
Total	2,965 (58.7)	2,082 (41.3)	N/A
Median follow-up time, m (IQR)	28 (16–46)	28 (15–45)	0.840
Median age (IQR)	60 (52–67)	58 (50–66)	0.002
Age group, years			0.007
≤35	108 (3.6)	91 (4.4)
36–45	300 (10.1)	249 (11.9)
46–55	637 (21.5)	489 (23.5)
56–65	1,044 (35.2)	685 (32.9)
66–75	627 (21.2)	381 (18.3)
>75	249 (8.4)	187 (9.0)
Tumor site			0.006
Colon	1,221 (41.2)	940 (45.1)
Rectum	1,722 (58.1)	1,130 (54.3)
N/A	22 (0.7)	12 (0.6)
TNM stage			0.220
I	525 (17.7)	443 (21.3)
II	1,022 (34.5)	625 (30.0)
III	1,418 (47.8)	1,014 (48.7)
Differentiated grade			0.248
Poor	721 (24.3)	493 (23.7)
Moderate	1,988 (67.1)	1,481 (71.1)
Well	62 (2.1)	45 (2.2)
N/A	194 (6.5)	63 (3.0)
Lymphatic or vascular invasion			0.076
Yes	707 (23.8)	452 (21.7)
No	2,258 (76.2)	1,630 (78.3)
Neural invasion			<0.001
Yes	606 (20.4)	319 (15.3)
No	2,359 (79.6)	1,763 (84.7)

Abbreviations: m, months; IQR, interquartile range; N/A, not available.

Table 2 Distribution of stages in different age groups between male and female patients

Age Group (years)	Male, n (%)			Female, n (%)			All, n (%)
	Stage I	Stage II	Stage III	Stage I	Stage II	Stage III	Stage I	Stage II	Stage III
≤35	16 (14.8)	21 (19.5)	71 (65.7)	15 (16.5)	20 (22.0)	56 (61.5)	31 (15.6)	41 (20.6)	127 (63.8)
36–45	29 (9.7)	87 (29.0)	184 (61.3)	46 (18.5)	73 (29.3)	130 (52.2)	75 (13.7)	160 (29.1)	314 (57.2)
46–55	117 (18.4)	216 (33.9)	304 (47.7)	108 (22.1)	137 (28.0)	244 (49.9)	225 (20.0)	353 (31.3)	548 (48.7)
56–65	202 (19.4)	350 (33.5)	492 (47.1)	158 (23.1)	196 (28.6)	331 (48.3)	360 (20.8)	546 (31.6)	823 (47.6)
66–75	115 (18.3)	240 (38.3)	272 (43.4)	88 (23.1)	120 (31.5)	173 (45.4)	203 (20.1)	360 (35.7)	445 (44.2)
>75	46 (18.5)	108 (43.4)	95 (38.1)	28 (15.0)	79 (42.2)	80 (42.8)	74 (17.0)	187 (42.9)	175 (40.1)

Note: The P-values for the association of age group with TNM stage by the Cochran-Mantel-Haensel χ² test were <0.001, 0.144 and <0.001 among male, female and all patients, respectively.

Figure 1 Kaplan–Meier curves of DFS and OS in all patients and separate gender groups stratified by six consecutive age groups.

Note: DFS for all patients (A1), male patients (A2) and female patients (A3); OS for all patients (A2), male patients (B2) and female patients (C2).

Abbreviations: DFS, disease-free survival; OS, overall survival.

Figure 2 Kaplan–Meier curves of DFS and OS in male and female patients stratified by three different age groups.

Notes: DFS (A1) and OS (A2) for male patients; DFS (B1) and OS (B2) for female patients.

Abbreviations: DFS, disease-free survival; OS, overall survival.

Figure 3 Kaplan–Meier curves of DFS and OS in three different age groups stratified by gender.

Notes: DFS in patients ≤35 (A1), 36–75 (B1) and >75 (C1) years old; DFS in patients ≤35 (A2), 36–75 (B2) and >75 years old (C2).

Abbreviations: DFS, disease-free survival; OS, overall survival; ref, reference.

Figure 4 Forest plot for DFS based on multivariate COX model analyses of prognostic factors for both male and female colorectal cancer patients.

Abbreviation: DFS, disease-free survival.

Table S1 Univariate analyses of prognostic factors for DFS and OS based on Cox proportional hazard model between male and female CRC patients

Characteristics	DFS, HR (95% CI)				OS, HR (95% CI)
	Male	P-value	Female	P-value	Male	P-value	Female	P-value
Age
≤35	0.84 (0.53–1.32)	0.447	1.75 (1.17–2.61)	0.006	0.52 (0.25–1.10)	0.086	1.51 (0.88–2.59)	0.139
36–75	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A
>75	1.09 (0.83–1.44)	0.525	1.50 (1.11–2.03)	0.008	1.93 (1.44–2.59)	<0.001	2.40 (1.74–3.32)	<0.001
TNM stage
I	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A
II	1.66 (1.17–2.36)	0.005	2.48 (1.57–3.90)	<0.001	2.15 (1.32–3.50)	0.002	2.51 (1.29–4.91)	0.007
III	4.52 (3.28–6.22)	<0.001	6.07 (4.00–9.20)	<0.001	5.36 (3.40–8.45)	<0.001	9.13 (4.97–16.74)	<0.001
Tumor site
Colon	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A
Rectum	1.05 (0.89–1.24)	0.533	0.77 (0.63–0.94)	0.009	1.00 (0.81–1.23)	0.996	0.71 (0.56–0.91)	0.007
Differentiated grade
Poor	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A
Moderate–well	0.98 (0.81–1.18)	0.833	0.66 (0.54–0.82)	<0.001	1.03 (0.81–1.32)	0.801	0.57 (0.44–0.74)	<0.001
Lymphatic or vascular invasion
No	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A
Yes	1.05 (0.87–1.26)	0.615	2.00 (1.63–2.46)	<0.001	0.93 (0.73–1.18)	0.540	2.19 (1.70–2.82)	<0.001
Neural invasion
No	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A
Yes	1.09 (0.90–1.32)	0.394	1.45 (1.14–1.85)	0.003	0.90 (0.70–1.17)	0.429	1.43 (1.06–1.94)	0.020

Abbreviations: CRC, colorectal cancer; DFS, disease-free survival; OS, overall survival, ref, reference; N/A, not available.

Table S2 Multivariate analyses of prognostic factors for DFS and OS based on Cox proportional hazard model between male and female CRC patients

Characteristics	DFS, HR (95% CI)				OS, HR (95% CI)
	Male	P-value	Female	P-value	Male	P-value	Female	P-value
Age
≤35	0.68 (0.43–1.10)	0.115	1.57 (1.03–2.38)	0.035	0.38 (0.17–0.86)	0.020	1.17 (0.65–2.11)	0.592
36–75	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A
>75	1.16 (0.87–1.55)	0.313	1.51 (1.11–2.05)	0.009	2.17 (1.61–2.93)	<0.001	2.54 (1.82–3.55)	<0.001
TNM stage
I	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A	1.0 (ref)	N/A
II	1.60 (1.11–2.29)	0.012	2.35 (1.46–3.78)	<0.001	1.97 (1.19–3.26)	0.009	2.02 (1.03–3.97)	0.042
III	4.60 (3.31–6.39)	<0.001	5.43 (3.50–8.43)	<0.001	5.57 (3.49–8.89)	<0.001	7.70 (4.17–14.23)	<0.001
Tumor site	1.11 (0.94–1.31)	0.238	0.85 (0.69–1.04)	0.121	1.08 (0.87–1.34)	0.471	0.80 (0.62–1.03)	0.079
Differentiated grade	0.99 (0.82–1.21)	0.942	0.80 (0.64–1.00)	0.051	0.99 (0.77–1.27)	0.952	0.70 (0.53–0.92)	0.011
Lymphatic or vascular invasion	0.97 (0.80–1.18)	0.733	1.39 (1.11–1.74)	0.004	0.92 (0.71–1.18)	0.501	1.27 (0.96–1.67)	0.090

Abbreviations: CRC, colorectal cancer; DFS, disease-free survival; OS, overall survival; ref, reference; N/A, not available.