P-0258 - Colorectal Carcinoma in Pediatric Age Group-Epidemiological Paradigm

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Cancer Aetiology, Epidemiology, Prevention
Colon Cancer
Rectal Cancer
Cancer in Special Situations
Presenter Deepak Jain
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors D. Jain1, R. Mathur2, B. Lahoti2
  • 1Tata Memorial Hospital, Mumbai/IN
  • 2M.G.M. Medical College, M.Y. Hospital & Govt, Cancer Hospital, Indore/IN

Abstract

Introduction

Colorectal cancer is a rare disease in pediatric age group with an annual incidence of 1.3 cases per million children. Spectrum of colorectal cancer includes the pediatric population also, which usually presents at advanced stage, unfavorable histology and ultimately poor prognosis. Difficult differential diagnosis, delay in presentation and aggressive biological behavior leads to poor outcome. We retrospectively analyzed the Clinical & pathological features, outcome & follow up of colorectal cancer patients referred to us.

Methods

Retrospective analysis of all pediatric colorectal cancer patients presented to Division of Pediatric Oncology between June 2006 to June 2012 were included in the study. A specifically designed audit form was devised to capture all relevant information regarding clinical presentation, pathologic factors, treatment outcome, prognostic factors and follow up.

Results

During the study period of 6 years from June 2006 to June 2012 only 7 cases of pediatric colorectal cancer were reported. Median age was 11.8 years [range, 5-16years]. All patients presented to our department were males. Five patients presented with features of intestinal obstruction and diagnosed during emergency laparotomy. One patient had history of bleeding per rectum & mass protruding from rectum. One patient had presenting complaints of altered bowel habits, bleeding per rectum and also family history of one brother died of colorectal cancer in past. The most common site of involvement was rectum (59%) & transverse colon being the next most common site (26%). Adenocarcinoma was histological type in all patients. Signet ring cell histology was found in 3 patients. 3 patients died within 2 years of follow-up. Rest 4 patients are receiving treatment and under follow-up.

Conclusion

Colorectal cancer is a rare disease in pediatric age group. Diagnostic dilemma, difficult differential diagnosis, delayed presentation & treatment, advanced stage and poor histological features contributes to the poor prognosis of the disease in pediatric age group as compared to adults. As in adult colorectal cancer; early detection, stage stratification, multidisciplinary treatment plan and participation in prospective clinical trials will help in improving the prognosis & outcome in pediatric patients.