P-243 - Clinicopathologic features and survival outcomes of colorectal cancer in young patients: Experience from a cancer institute in Peru

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Cancer in Young Adults
Colon Cancer
Rectal Cancer
Pathology/Molecular Biology
Presenter R. Ruiz
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors R. Ruiz1, P. Montenegro1, L. Taxa1, L. Casanova1, E. Ruiz2
  • 1Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima/PE
  • 2Universidad Peruana Cayetano Heredia (UPCH), Lima/PE

Abstract

Introduction

Several studies suggest that the incidence of colorectal cancer (CRC) in young patients is rising. The results regarding its characteristics and prognosis are controversial. The aim of this study was to determine the clinicopathologic features and survival outcome of CRC in Peruvian young patients.

Methods

Retrospective analysis of patients 40 years old or younger diagnosed with CRC between 2005 and 2010 at Instituto Nacional de Enfermedades Neoplásicas (INEN) in Lima, Peru. Data was retrieved from clinical files. Kaplan-Meier method was used to estimate the 5-year overall survival (OS).

Results

During the study period, 196 young patients with CRC were admitted. The male to female ratio was 1:1.06. Age ranged between 11 to 40 years (mean age 32.9 years). The tumor was located in the rectum, distal colon and proximal colon in 45.9%, 28.6% and 25.5%, respectively. CRC family was found in 13.2% and an autosomic pattern of inheritance was detected in 8.6% of the cases. The most common symptoms were pain (67.9%) and bleeding (67.3%). Twenty percent presented with obstruction and/or perforation. CEA was abnormally increased (≥ 5ng/dl) in 32.7% of cases. Twenty-five percent of all patients had metastatic disease at the diagnosis: 33% in colon cancer and 16% in rectal cancer. The histological type corresponded to tubular adenocarcinoma, mucinous and signet-ring cell carcinoma in 73.5%, 14.8% and 8.6%, respectively. The tumors were high-grade in 14.3% of the cases. Half of the patients had curative-intent surgery and 40.3% had any kind of palliative treatment. The remaining patients did not receive any therapy. The 5-year OS for the entire group was 44.3%; for patients with colon and rectal cancer that underwent curative-intent surgery was 69.4% and 67.4%, respectively.

Conclusion

CRC in young patients is mostly sporadic. It usually presents in the rectum or distal colon. Metastatic disease at diagnosis and histological sub-types other than adenocarcinoma are more frequent when compared to adult series. These features suggest a more aggressive disease.

Figure: P-243