{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:28:19Z","timestamp":1791919699083,"version":"4.3.4"},"reference-count":33,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T00:00:00Z","timestamp":1732579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Colorectal cancer (CRC) ranks as the third most prevalent cancer globally and is the third leading cause of cancer-related deaths. In 2020 alone, there were over 1.9 million new cases of CRC and nearly 0.9 million deaths worldwide. The incidence and outcomes of CRC exhibit significant geographical and temporal variations, largely influenced by diverse risk factors among populations. Recognizing the prognostic factors and the presenting symptoms of CRC, a leading global cancer with high mortality, can enhance early detection and thereby improve clinical outcomes. Materials and Methods: This retrospective, observational study analyzed 724 CRC elderly patients aged 70 and over (median age 80, 53.17% male), treated at a single center. Data on demographics, clinical characteristics, and outcomes were collected. Overall survival was analyzed using Kaplan\u2013Meier curves, with stratification based on tumor location, disease staging, lymph node involvement, and family history. Results: Our study encompassed all CRC cases treated with surgery and systemic therapies (chemotherapy or biological agents) from July 2002 to September 2020. We focused on comparing prognosis between left-sided and right-sided CRC, as well as rectal cancer. We found that left-sided CRC demonstrated a superior prognosis compared to rectal cancer (p = 0.0022). Furthermore, among patients with CRC, tumors originating in the rectum were associated with worse outcomes compared to those arising in both the right and left colon, regardless of disease stage (p = 0.0049). Additionally, a family history of CRC was associated with poorer prognosis, impacting both metastatic (p = 0.0022) and localized disease (p = 0.035). The main symptoms prompting patients to start an investigation of CRC were abdominal pain (31.49%), anemia (18.08%), rectal bleeding (hematochezia) (17.82%), change in bowel habits (9.94%), and weight loss (7.60%). Conclusions: This study provides valuable insights into the symptoms prompting initial investigation and the prognostic factors associated with CRC in an elderly population with varied characteristics. It underscores the need for increased vigilance in recognizing key symptoms and the importance of personalized treatment strategies tailored to these prognostic factors.<\/jats:p>","DOI":"10.3390\/medicina60121951","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T04:20:12Z","timestamp":1732681212000},"page":"1951","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Colorectal Cancer in Elderly Patients: Insights into Presentations, Prognosis, and Patient Outcomes"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7570-4550","authenticated-orcid":false,"given":"Walid","family":"Shalata","sequence":"first","affiliation":[{"name":"The Legacy Heritage Cancer Center, Dr. Larry Norton Institute, Soroka Medical Center, Beer-Sheva 84105, Israel"},{"name":"Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Gluzman","sequence":"additional","affiliation":[{"name":"The Legacy Heritage Cancer Center, Dr. Larry Norton Institute, Soroka Medical Center, Beer-Sheva 84105, Israel"},{"name":"Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Man","sequence":"additional","affiliation":[{"name":"The Legacy Heritage Cancer Center, Dr. Larry Norton Institute, Soroka Medical Center, Beer-Sheva 84105, Israel"},{"name":"Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahron Yehonatan","family":"Cohen","sequence":"additional","affiliation":[{"name":"The Legacy Heritage Cancer Center, Dr. Larry Norton Institute, Soroka Medical Center, Beer-Sheva 84105, Israel"},{"name":"Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf","family":"Abu Jama","sequence":"additional","affiliation":[{"name":"The Legacy Heritage Cancer Center, Dr. Larry Norton Institute, Soroka Medical Center, Beer-Sheva 84105, Israel"},{"name":"Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itamar","family":"Gothelf","sequence":"additional","affiliation":[{"name":"Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Tourkey","sequence":"additional","affiliation":[{"name":"The Legacy Heritage Cancer Center, Dr. Larry Norton Institute, Soroka Medical Center, Beer-Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ala Eddin","family":"Neime","sequence":"additional","affiliation":[{"name":"Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Abu Juma\u2019a","sequence":"additional","affiliation":[{"name":"Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keren","family":"Peri-Hanania","sequence":"additional","affiliation":[{"name":"PhaseV Trials Ltd., Tel Aviv 67443, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oshri","family":"Machluf","sequence":"additional","affiliation":[{"name":"PhaseV Trials Ltd., Tel Aviv 67443, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gal","family":"Shoham Levin","sequence":"additional","affiliation":[{"name":"PhaseV Trials Ltd., Tel Aviv 67443, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sondos","family":"Shalata","sequence":"additional","affiliation":[{"name":"Nutrition Unit, Galilee Medical Center, Nahariya 22000, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahab","family":"Hayadri","sequence":"additional","affiliation":[{"name":"Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ez El Din","family":"Abu Zeid","sequence":"additional","affiliation":[{"name":"Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nashat","family":"Abu Yasin","sequence":"additional","affiliation":[{"name":"The Legacy Heritage Cancer Center, Dr. Larry Norton Institute, Soroka Medical Center, Beer-Sheva 84105, Israel"},{"name":"Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amichay","family":"Meirovitz","sequence":"additional","affiliation":[{"name":"The Legacy Heritage Cancer Center, Dr. Larry Norton Institute, Soroka Medical Center, Beer-Sheva 84105, Israel"},{"name":"Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Yakobson","sequence":"additional","affiliation":[{"name":"The Legacy Heritage Cancer Center, Dr. Larry Norton Institute, Soroka Medical Center, Beer-Sheva 84105, Israel"},{"name":"Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2179","DOI":"10.1136\/gutjnl-2019-319511","article-title":"Global patterns and trends in colorectal cancer incidence in young adults","volume":"68","author":"Siegel","year":"2019","journal-title":"Gut"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"El Din, K.S., Loree, J.M., Sayre, E.C., Gill, S., Brown, C.J., Dau, H., and De Vera, M.A. (2020). Trends in the epidemiology of young-onset colorectal cancer: A worldwide systematic review. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-06766-9"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.ypmed.2017.10.007","article-title":"Increasing colorectal cancer incidence trends among younger adults in Canada","volume":"105","author":"Brenner","year":"2017","journal-title":"Prev. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1136\/gutjnl-2018-317592","article-title":"Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years","volume":"68","author":"Vuik","year":"2019","journal-title":"Gut"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S2468-1253(19)30147-5","article-title":"Changes in colorectal cancer incidence in seven high-income countries: A population-based study","volume":"4","author":"Araghi","year":"2019","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1001\/jamasurg.2014.1756","article-title":"Increasing Disparities in the Age-Related Incidences of Colon and Rectal Cancers in the United States, 1975-2010","volume":"150","author":"Bailey","year":"2015","journal-title":"JAMA Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e2413157","DOI":"10.1001\/jamanetworkopen.2024.13157","article-title":"Red Flag Signs and Symptoms for Patients with Early-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis","volume":"7","author":"Demb","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.4251\/wjgo.v16.i5.2141","article-title":"Systematic review of risk factors, prognosis, and management of colorectal signet-ring cell carcinoma","volume":"16","author":"Nuytens","year":"2024","journal-title":"World J. Gastrointest. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Xu, P., Tao, Z., Yang, H., and Zhang, C. (2024). Obesity and early-onset colorectal cancer risk: Emerging clinical evidence and biological mechanisms. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1366544"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/j.cgh.2021.01.037","article-title":"Risk Factors for Early-Onset Colorectal Cancer: A Systematic Review and Meta-analysis","volume":"20","author":"Sutherland","year":"2022","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1097\/MEG.0000000000002000","article-title":"Risk factors and clinical characteristics of early-onset colorectal cancer vs. late-onset colorectal cancer: A case-case study","volume":"33","author":"Zuppardo","year":"2021","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Meenakshi, D.U., Narde, G.K., Ahuja, A., Al Balushi, K., Francis, A.P., and Alam Khan, S. (2024). Therapeutic Applications of Nanoformulated Resveratrol and Quercetin Phytochemicals in Colorectal Cancer\u2014An Updated Review. Pharmaceutics, 16.","DOI":"10.3390\/pharmaceutics16060761"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Alfonso, P., Mu\u00f1oz, A., Jim\u00e9nez-Castro, J., Jim\u00e9nez-Fonseca, P., Pericay, C., Longo-Mu\u00f1oz, F., Reyna-Fortes, C., Argil\u00e9s-Mart\u00ednez, G., Gonz\u00e1lez-Astorga, B., and G\u00f3mez-Reina, M.J. (2021). Early Clinical Experience with Trifluridine\/Tipiracil for Refractory Metastatic Colorectal Cancer: The ROS Study. Cancers, 13.","DOI":"10.3390\/cancers13184514"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1136\/gutjnl-2022-327736","article-title":"Global burden of colorectal cancer in 2020 and 2040: Incidence and mortality estimates from GLOBOCAN","volume":"72","author":"Morgan","year":"2023","journal-title":"Gut"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Tsai, K.-Y., Huang, P.-S., Chu, P.-Y., Nguyen, T.N.A., Hung, H.-Y., Hsieh, C.-H., and Wu, M.-H. (2024). Current Applications and Future Directions of Circulating Tumor Cells in Colorectal Cancer Recurrence. Cancers, 16.","DOI":"10.3390\/cancers16132316"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.21037\/jgo.2019.06.03","article-title":"Making sense of adjuvant chemotherapy in colorectal cancer","volume":"10","author":"Chan","year":"2019","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1200\/JCO.20.01330","article-title":"Duration of Adjuvant Doublet Chemotherapy (3 or 6 months) in Patients with High-Risk Stage II Colorectal Cancer","volume":"39","author":"Iveson","year":"2021","journal-title":"J. Clin. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Ryu, H.S., Kim, J., Park, Y.R., Cho, E.H., Choo, J.M., Kim, J.-S., Baek, S.-J., and Kwak, J.-M. (2023). Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies. Cancers, 15.","DOI":"10.3390\/cancers15245791"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"204","DOI":"10.4251\/wjgo.v7.i10.204","article-title":"Treatment of colorectal cancer in the elderly","volume":"7","author":"Millan","year":"2015","journal-title":"World J. Gastrointest. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Itatani, Y., Kawada, K., and Sakai, Y. (2018). Treatment of Elderly Patients with Colorectal Cancer. BioMed Res. Int., 2018.","DOI":"10.1155\/2018\/2176056"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"329","DOI":"10.6004\/jnccn.2021.0012","article-title":"Colon Cancer, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology","volume":"19","author":"Benson","year":"2021","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s10689-004-9546-y","article-title":"Trends in colorectal cancer incidence and mortality in the Israeli Jewish ethnic populations","volume":"3","author":"Barchana","year":"2004","journal-title":"Fam. Cancer"},{"key":"ref_25","unstructured":"The Israel Cancer Association (2024, August 08). Colorectal Cancer. Available online: https:\/\/en.cancer.org.il\/template_e\/default.aspx?PageId=7747."},{"key":"ref_26","unstructured":"The Israeli Ministry of Health (2020, December 23). Data Update for Cancer Incidence and Mortality in Israel in 2017, (In Hebrew)."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Magid, A., Robinson, E., and Keinan-Boker, L. (2022). Preventable Cancer in Israel. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191710521"},{"key":"ref_28","unstructured":"The Israeli Ministry of Health (2020, December 23). Israel National Health Interview Survey INHIS-3, 2013\u20132015\u2014Selected Findings. Israel Center for Disease Control, Ministry of Health, (In Hebrew)."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3322\/caac.21820","article-title":"Cancer Statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.gtc.2007.12.002","article-title":"Pathophysiology, Clinical Presentation, and Management of Colon Cancer","volume":"37","author":"Cappell","year":"2008","journal-title":"Gastroenterol. Clin. North Am."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.clcc.2022.05.006","article-title":"Clinical Updates for Colon Cancer Care in 2022","volume":"21","author":"Fabregas","year":"2022","journal-title":"Clin. Color. Cancer"},{"key":"ref_32","first-page":"351","article-title":"From colonic polyps to colon cancer: Pathophysiology, clinical presentation, screening and colonoscopic therapy","volume":"53","author":"Cappell","year":"2007","journal-title":"Minerva Gastroenterol. Dietol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Katsaounou, K., Nicolaou, E., Vogazianos, P., Brown, C., Stavrou, M., Teloni, S., Hatzis, P., Agapiou, A., Fragkou, E., and Tsiaoussis, G. (2022). Colon Cancer: From Epidemiology to Prevention. Metabolites, 12.","DOI":"10.3390\/metabo12060499"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/12\/1951\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:40:06Z","timestamp":1760114406000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/12\/1951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,26]]},"references-count":33,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["medicina60121951"],"URL":"https:\/\/doi.org\/10.3390\/medicina60121951","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,26]]}}}