Colorectal Carcinoma in Childhood and Adolescence: A Clinicopathologic Review
- 20 December 2007
- journal article
- pediatric oncology
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 25 (36), 5808-5814
- https://doi.org/10.1200/jco.2007.12.6102
Abstract
Purpose Pediatric colorectal carcinoma (CRC) is rare, but the available data suggest that it is more likely than adult CRC to be advanced at presentation and to have a poor outcome. We sought to better characterize pediatric CRC. Patients and Methods We reviewed the clinical and pathologic features, prognostic factors, and outcome of CRC in 77 children and adolescents (ages 7 to 19 years) referred to St Jude Children's Research Hospital between 1964 and 2003. Results At presentation, 76 patients had one or more signs or symptoms of CRC (abdominal pain, altered bowel habits, weight loss, anemia). Tumors were evenly distributed between the right and left colon; 62% were mucinous adenocarcinoma. At presentation, 86% of patients had advanced-stage disease; more than half had distant metastases. Overall outcome was poor. Advanced stage and mucinous histology were significant predictors of adverse outcome. Stage-specific survival at 10 years was 67% ± 27% (stage 1), 38% ± 15% (stage 2), 28% ± 11% (stage III), and 7% ± 4% (stage 4). Although no patient had a diagnosis of polyposis syndrome before diagnosis of CRC, 17 (22%) had colon polyps and eight (including two who previously underwent pelvic radiotherapy) had multiple polyps. Conclusion Initial signs and symptoms of CRC are similar in pediatric and adult patients. The strikingly higher frequency of mucinous histology suggests that the biology of CRC differs in pediatric and adult patients and may contribute to poor outcomes. Children should be included in prospective clinical trials for CRC.This publication has 23 references indexed in Scilit:
- Colorectal Cancers in Children without any Predisposing Factors. A Report of Eight Cases and Review of the LiteratureEuropean Journal of Pediatric Surgery, 2003
- Colorectal Carcinoma in Children and Adolescents - A Report of Seven CasesEuropean Journal of Pediatric Surgery, 2001
- Colorectal carcinoma in childrenJournal of Pediatric Surgery, 1999
- Prognostic factors and outcome in patients 21 years and under with colorectal carcinomaJournal of Pediatric Surgery, 1992
- Colorectal carcinoma in childrenJournal of Pediatric Surgery, 1992
- Carcinoma of the Colon in ChildrenJournal of Pediatric Gastroenterology and Nutrition, 1991
- Carcinoma of the Colon and Rectum in Patients Less Than 20 Years of AgeSouthern Medical Journal, 1990
- Colorectal adenocarcinoma in childhood and adolescentPediatric Radiology, 1989
- Adenocarcinoma of the colon in adolescentsThe American Journal of Surgery, 1988
- Colon carcinoma in children and adolescents. A review of 30 casesCancer, 1985