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Session:: ePosters-Sun800-M2: Colon & Colorectal Cancer

EP215 - Effect of facility type on outcomes of early onset colon cancer: Comparative analysis of quality of oncologic resection and survival.

Sunday, May 10, 2026
8:32 AM - 8:37 AM ET

    ePoster Presenter(s)

  • Seyed Ali Mousavi Almaleki, MD (he/him/his)

    Research Associate
    University of Texas Southwestern Medical Center
    University of Texas southwestern Medical center
    Dallas, TX, United States

    Disclosure information not submitted.

    • Author(s)

  • LX

    Lai Xue, MD FACS

    Assistant Professor
    UT Southwestern Medical Center
    Dallas, Texas, United States

    Disclosure information not submitted.

  • JS

    Javier Salgado Pogacnik, MD

    Faculty
    UT Southwestern
    Dallas, Texas, United States

    Disclosure information not submitted.

  • SC

    Sitaram Chilakamarry, MD

    Assistant Professor
    UT Southwestern Medical Center
    Dallas, Texas, United States

    Disclosure information not submitted.

  • LL

    Laindy Liu, MD FACS

    Assistant Professor
    UT Southwestern Medical Center
    Dallas, Texas, United States

    Disclosure information not submitted.

  • AS

    Alessandra Storino Gonzalez, MD FACS

    Assistant Professor
    UT Southwestern Medical Center
    Dallas, Texas, United States

    Disclosure information not submitted.

  • Emina Huang, MD, MBA

    Professor of Surgery, Vice-Chair for Research Department of Surgery
    University of Texas Southwestern
    University of Texas
    Dallas, TX, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • FA

    Fadwa Ali, MD

    Assistant Professor
    UT Southwestern Medical Center
    Dallas, Texas, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Emina Huang, MD, MBA: This individual has no financial relationships with ineligible companies.
Purpose/Background: Colon cancer is a leading cause of cancer-related mortality worldwide. Young-onset colon cancer is increasing in incidence, yet outcomes across treatment facilities remain understudied. This population is vulnerable due to the limitations of screening in this age group and unrecognized symptoms. In this study, we aim to compare differences in oncologic outcomes in patients with young-onset colon cancer, stratified by Commission on Cancer (CoC) cancer program facility type.

Methods/Interventions:

Methods:

Patients under 50 years of age with a diagnosis of colon adenocarcinoma were identified from the National Cancer Database (NCDB) from 2004 to 2022. Facility type was defined as Community Cancer Program (CCP), Comprehensive Community Cancer Program (CCCP), Academic Comprehensive Cancer Program (ACCP), and Integrated Network Cancer Program (INCP). The endpoint was to assess differences in demographics, stage at presentation, readmission, and 30 and 90-day mortality, quality of oncologic resection, and survival among different facilities.

Results/Outcomes:

Results:

A total of 98056 patients from NCDB were included in the study. 7.5% were treated at CCP (n = 7,325), 37.7% at CCCP (n = 36,962), 34.6% at ACCP (n = 33,898), and 20.3% at INCP (n = 19,871). There was no significant difference in gender distribution across facility types (P = 0.232). Racial distribution differed significantly across facility types, with Academic Centers treating a lower proportion of White patients and a higher proportion of African American and Hispanic populations compared to other settings, P< 0.001. The proportion of patients with Stage III disease was 31.8% at CCP, 32.1% at CCCP, 29.7% at ACCP, and 32.7% at INCP. For Stage IV disease, ACCP treated a higher proportion (34.1%) compared to CCP (26.1%), CCCP (26.3%), and INCP (26.6%), P< 0.001. Academic centers had the highest rate of adequate lymph node Harvest (90.3%), P< 0.001. Positive surgical margins were significantly lower in ACCP in comparison to CCCP, P=0.047.

In a multivariable Cox regression model adjusted for pathologic stage, adequate lymph node harvest, and surgical margin status, treatment at ACCP was associated with significantly improved overall survival in young-onset colon cancer, with a 13% lower hazard of death compared to CCP (HR 0.871), P< 0.001. Positive surgical margins were associated with a nearly twofold increased risk of death (HR 1.99), and Inadequate lymph node harvest ( < 12 nodes) was linked to 58% increased hazard ratio (HR 1.58). Moreover, the advancing stage remained the strongest predictor of poor survival (HR 2.46).

Conclusion/Discussion:

Conclusion:

Treatment at ACCP was independently associated with improved overall survival. This difference appeared to be largely driven by the quality of oncologic resection. Positive surgical margins and inadequate lymph node harvest were significantly related to worse outcomes. Also, the advancing stage at diagnosis remained the most powerful predictor of poor prognosis. Efforts to standardize surgical care, regardless of facility type, may help reduce disparities in outcomes.

Multivariable Analysis of Risk Factors Associated with Increased Mortality in Young-Onset Colon Cancer