Patients with early-onset rectal cancer aged 40 year or less have similar oncologic outcomes to older patients despite presenting in more advanced stage; A retrospective cohort study
- 25 September 2020
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in International Journal of Surgery
- Vol. 83, 161-168
- https://doi.org/10.1016/j.ijsu.2020.09.029
Abstract
Background: Early-onset colon and rectal cancer has increased in alarming rates. The present study reviewed the characteristics and outcome of early-onset rectal cancer in patients aged ≤40 years. Methods: This was a retrospective cohort study on rectal cancer patients who were treated in a tertiary center in the Middle East. Baseline characteristics and outcomes of patients ≤ 40 years were compared with patients >40 years. Main outcome measures were patients’ and tumor characteristics, local recurrence, distance metastasis, overall survival (OS), and disease-free survival (DFS). Results: Among 244 patients with rectal cancer, 81 (33.2%) aged 40 years or less. 56.8% of patients ≤ 40 years and 49.7% of patients >40 years presented with stage III/IV disease (p=0.36). Local recurrence and distant metastasis were detected in 10.3% and 13.2% of patients ≤ 40 years and in 16.9% and 13.9% of patients > 40 years (p=0.29 and 0.88). The 3-year OS and DFS rates of patients ≤ 40 years were 75% and 80.9% versus 74.2% and 76.5% in patients > 40 years (p=0.9 and 0.59). Patients ≤ 40 years presented with ulcerative carcinoma (38.3% vs 21.5%, p=0.01) and signet-ring carcinoma (12.3% vs 2.5%, p=.008) more than patients > 40 years. Conclusion: Early-onset rectal cancer accounted for one-third of all patients presenting with rectal cancer. Patients younger than 40 years had higher incidence of mucinous and signet-ring rectal carcinoma, and presented more with advanced stage. The age of patients did not have a significant impact on the oncologic outcome of rectal cancer.Keywords
This publication has 33 references indexed in Scilit:
- Prognostic factors associated with locally recurrent rectal cancer following primary surgery (Review)Oncology Letters, 2013
- Colorectal cancer: are the “young” being overlooked?The American Journal of Surgery, 2013
- Differences in clinicopathological characteristics of colorectal cancer between younger and elderly patients: an analysis of 322 patients from a single institutionThe American Journal of Surgery, 2011
- Colorectal carcinoma in different age groupsInternational Journal of Colorectal Disease, 2011
- Is Gender Related to the Stage of Colorectal Cancer at Initial Presentation in Young Patients?Journal of Surgical Research, 2011
- Increasing incidence of rectal cancer in patients aged younger than 40 yearsCancer, 2010
- Colorectal Carcinoma in Childhood and Adolescence: A Clinicopathologic ReviewJournal of Clinical Oncology, 2007
- Classification of Surgical ComplicationsAnnals of Surgery, 2004
- Colorectal Cancer in EgyptDiseases of the Colon & Rectum, 2002
- Colorectal cancer in patients under 40 years of ageDiseases of the Colon & Rectum, 1986