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Current Cancer Therapy Reviews

Editor-in-Chief

ISSN (Print): 1573-3947
ISSN (Online): 1875-6301

Research Article

Rectal Cancer in Patients Younger than 40: Tumor Characteristics and Comparative Survival Based on a Single Institution

Author(s): Lara Hilal, Ayman Hakim, Alissar El-Chediak, Sally Temraz, Deborah Mukherji, Ziad El-Husseini and Ali Shamseddine*

Volume 17, Issue 3, 2021

Published on: 13 November, 2020

Page: [244 - 250] Pages: 7

DOI: 10.2174/1573394716999201113141003

Price: $65

Abstract

Aim: The aim of this study was to determine tumor characteristics and outcomes of patients with rectal cancer <40 years old compared to those above that age at a single institution in Lebanon.

Background: The incidence of colorectal cancer is increasing in younger adults as observed from limited available data from the Middle East.

Objective: Overall survival (OS) and disease-free survival (DFS) were estimated using Kaplan- Meier.

Methods: We conducted a retrospective study of patients who were diagnosed with rectal cancer over 15 years. Data were collected regarding demographics, stage, pathology, treatment, and outcomes. Patients were stratified by age, with 40 years as cut-off. Descriptive statistics were conducted.

Results: Data for 105 cases were reviewed, 18 patients were aged under 40 years old and 87 patients were above 40 years old. Younger patients had more poorly differentiated tumors than older patients and were more likely to have tumors with signet-ring features. 5-year DFS was 35% and 51.5% for patients below and above 40 years old, respectively (P=0.04). OS was similar in the two age groups, with a median follow-up of 36 months.

Conclusion: Further prospective studies with larger sample size and molecular markers are needed to better understand the characteristics of rectal cancer in the young age group. With worse DFS in our study and emerging evidence of a correlation between younger age at diagnosis and poor outcomes, consideration should be given to more personalized upfront intensification of treatment in the young.

Keywords: Rectal cancer, young age group, prognosis, disease-free survival, colorectal cancer, tumor.

Graphical Abstract
[1]
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin 2020; 70(1): 7-30.
[http://dx.doi.org/10.3322/caac.21590] [PMID: 31912902]
[2]
Bethesda M. SEER cancer statistics factsheets: Colon and rectum cancer. 2016.
[3]
Inra JA, Syngal S. Colorectal cancer in young adults. Dig Dis Sci 2015; 60(3): 722-33.
[http://dx.doi.org/10.1007/s10620-014-3464-0] [PMID: 25480403]
[4]
Boyle P, Langman JS. ABC of colorectal cancer: Epidemiology. BMJ 2000; 321(7264): 805-8.
[http://dx.doi.org/10.1136/bmj.321.7264.805] [PMID: 11009523]
[5]
Veruttipong D, Soliman AS, Gilbert SF, et al. Age distribution, polyps and rectal cancer in the Egyptian population-based cancer registry. World J Gastroenterol 2012; 18(30): 3997-4003.
[http://dx.doi.org/10.3748/wjg.v18.i30.3997] [PMID: 22912550]
[6]
Mahmodlou R, Mohammadi P, Sepehrvand N. Colorectal cancer in northwestern iran. ISRN Gastroenterol 2012; 2012: 968560.
[http://dx.doi.org/10.5402/2012/968560] [PMID: 22754700]
[7]
Amin TT, Suleman W, Al Taissan AA, Al Joher AL, Al Mulhim O, Al Yousef AH. Patients’ profile, clinical presentations and histopathological features of colo-rectal cancer in Al Hassa region, Saudi Arabia. Asian Pac J Cancer Prev 2012; 13(1): 211-6.
[http://dx.doi.org/10.7314/APJCP.2012.13.1.211] [PMID: 22502671]
[8]
Al-Jaberi TM, Yaghan RJ, El-Heis HA. Colorectal cancer in young patients under 40 years of age. Comparison with old patients in a well defined Jordanian population. Saudi Med J 2003; 24(8): 871-4.
[PMID: 12939675]
[9]
Zorluoglu A, Yilmazlar T, Ozguc H, Bagcivan E, Guner O. Colorectal cancers under 45 years of age. Hepatogastroenterology 2004; 51(55): 118-20.
[PMID: 15011844]
[10]
Shamseddine A, Saleh A, Charafeddine M, et al. Cancer trends in Lebanon: A review of incidence rates for the period of 2003-2008 and projections until 2018. Popul Health Metr 2014; 12(1): 4.
[http://dx.doi.org/10.1186/1478-7954-12-4] [PMID: 24593777]
[11]
Adib SM, Daniel J. Ministry of public health national cancer registry cancer in lebanon 2003. Natl Cancer Regist 2006.
[12]
Zbuk K, Sidebotham EL, Bleyer A, La Quaglia MP. Colorectal cancer in young adults. Semin Oncol 2009; 36(5): 439-50.
[http://dx.doi.org/10.1053/j.seminoncol.2009.07.008] [PMID: 19835739]
[13]
Ahnen DJ, Wade SW, Jones WF, et al. The increasing incidence of young-onset colorectal cancer: a call to action. Mayo Clin Proc 2014; 89(2): 216-24.
[http://dx.doi.org/10.1016/j.mayocp.2013.09.006] [PMID: 24393412]
[14]
Endreseth BH, Romundstad P, Myrvold HE, Hestvik UE, Bjerkeset T, Wibe A. Norwegian Rectal Cancer Group. Rectal cancer in the young patient. Dis Colon Rectum 2006; 49(7): 993-1001.
[http://dx.doi.org/10.1007/s10350-006-0558-6] [PMID: 16741599]
[15]
Salem ME, Arun M, Dyson G, et al. Characteristics of colorectal cancer in patients younger than 40 years compared to older patients. J Clin Oncol 2013; 31(4): 371.
[16]
Fu C-Y, Jao S-W, Wu C-C, et al. Comparisons of characteristics and outcome of colorectal cancer in different age categories: A retrospective analysis of a single institution in Taiwan. ROC Color Surg Med Assoc 2011; 22(3): 57-64.
[17]
Li Q, Cai G, Li D, Wang Y, Zhuo C, Cai S. Better long-term survival in young patients with non-metastatic colorectal cancer after surgery, an analysis of 69,835 patients in SEER database. Brody JP, editor PLoS One 2014; 9(4): e93756.
[18]
Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009; 45(2): 228-47.
[http://dx.doi.org/10.1016/j.ejca.2008.10.026] [PMID: 19097774]
[19]
O’Connell JB, Maggard MA, Livingston EH, Yo CK. Colorectal cancer in the young. Am J Surg 2004; 187(3): 343-8.
[http://dx.doi.org/10.1016/j.amjsurg.2003.12.020] [PMID: 15006562]
[20]
O’Connell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY. Do young colon cancer patients have worse outcomes? World J Surg 2004; 28(6): 558-62.
[http://dx.doi.org/10.1007/s00268-004-7306-7] [PMID: 15366745]
[21]
Tawadros PS, Paquette IM, Hanly AM, Mellgren AF, Rothenberger DA, Madoff RD. Adenocarcinoma of the rectum in patients under age 40 is increasing: impact of signet-ring cell histology. Dis Colon Rectum 2015; 58(5): 474-8.
[http://dx.doi.org/10.1097/DCR.0000000000000318] [PMID: 25850833]
[22]
Nagai Y, Hata K, Kawai K, et al. Clinicopathological features of colorectal cancer patients under the age of 50: Recent experience and case-control study of prognosis in a Japanese cohort. Digestion 2016; 93(4): 272-9.
[http://dx.doi.org/10.1159/000446344] [PMID: 27188463]
[23]
Cancer society. A cancer facts & figures 2002‎. Cancer Facts Fig 2002.
[24]
Lupattelli M, Matrone F, Gambacorta MA, et al. Preoperative intensity-modulated radiotherapy with a simultaneous integrated boost combined with Capecitabine in locally advanced rectal cancer: Short-term results of a multicentric study. Radiat Oncol 2017; 12(1): 139.
[http://dx.doi.org/10.1186/s13014-017-0870-4] [PMID: 28830475]
[25]
Willauer AN, Liu Y, Pereira AAL, et al. Clinical and molecular characterization of early-onset colorectal cancer. Cancer 2019; 125(12): 2002-10.
[http://dx.doi.org/10.1002/cncr.31994] [PMID: 30854646]

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