Clinicopathologic Predictors Of Worse Outcome In Early Onset Colorectal Cancer (Eo-Crc): A Single-Institution Experience.

e15064 Background: A growing body of evidence indicates an increasing incidence of CRC diagnosis prior to age 50 years. Despite improvements in morbidity and mortality in metastatic CRC (mCRC), racial disparities persist. Limited data is available on the influence of clinical and pathologic factors on outcomes in EO-CRC. We aim to analyze variables which may serve as prognostic markers in a racially diverse, under-served EO-CRC population. Methods: All mCRC patients (n=321) diagnosed between 2004-12 were identified through the institutional tumor registry and charts were reviewed for age at diagnosis, gender, race, site of primary and metastatic tumors and histologic grade. Clinical outcome was measured in terms of overall survival (OS). Clinicopathologic characteristics were compared with a t test between EO and standard onset (SO) groups. Multivariate analyses were performed to assess influence on EO-CRC. Results: Of the 321 patients, 60 (18.7%) had EO-CRC, with median age at diagnosis 42 years. Both groups showed a female preponderance (Table), with colon being the prevalent primary site (~70%). On analysis of racial distribution, non-Hispanic whites (NHW) and non-Hispanic blacks (NHB) had a lower incidence of EO-CRC compared with Hispanic (H) and Asian (A) patients (12.7% v 17.6% v 26.7% v 40%, p= 0.07). Additionally, EO-CRC had a higher incidence of high-grade histology (42.6% v 25.8%, p=0.09), which on multivariate analysis had a significant influence on clinical outcome (p<0.01). Median OS in the EO group was 2.1 years compared to 2.7 years in the SO group. Conclusions: EO-CRC is an aggressive malignancy with distinct pattern of racial distribution. Histologic grade has the potential to serve as a negative prognostic marker. Further analysis of patients diagnosed between 2013-18 is underway. [Table: see text]