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.

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.:

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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.

Int J Surg. 2020 Sep 24;:

Authors: Emile SH, Elfeki H, Shalaby M, Elbalka S, Metwally IH, Abdelkhalek M

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.



PMID: 32980517 [PubMed - as supplied by publisher]