58P - Clinicopathologic profile and outcomes of rectal cancer (RC) in the young (<50 years old): A single institution experience

Background

There is an increasing incidence of RC in the young. Clinicopathologic features are not clearly established especially in the local Filipino population. Moreover, treatment challenges occur in this population. This study aims to describe the clinicopathologic profile and outcomes in patients diagnosed with RC in the young at the Southern Philippines Medical Center, Adult Cancer Institute.

Methods

All RC patients were reviewed from January 2018 to December 2021. A total of 548 RC patients were reviewed retrospectively.

Results

A total of 99 patients were identified (18%) as RC in the young. Majority were males (68%) and have a family history of cancer (72%). Mean tumor distance was 4.82+6.0 cm from the anal verge. All patients had adenocarcinoma histology with 9% having mucinous component and 1% with signet ring features. For tumor differentiation, 56% had moderately and 23% had poorly differentiated tumors. Most patients were diagnosed with locally advanced disease (55% St IIIB, 12% St IIIC) and 24% with distant metastasis. Mean CEA levels were elevated (preoperative 59.44ng/ml and post-operative 49.42ng/ml). Among non-metastatic disease, most stage II and stage III RC patients received neoadjuvant long course chemoradiation (LCCRT) then Surgery then adjuvant chemotherapy (AC) (52%). Most common AC used was Capecitabine-Oxaliplatin. At the time of analysis, 57.6% had no evidence of disease while 38.4% progressed or metastasized to distant organs. In the overall population of RC in the young, median overall survival was 21.3 months (mos). Survival rate at 12 mos was 60% and at 24 mos was 40%.

Conclusions

RC in the young Filipino patient presented more with lower lying rectal tumors, moderately to poorly differentiated histology, and more advanced disease at diagnosis. Survival appeared to be worse compared to historical data. Improved understanding of this specific subgroup is necessary for better treatment options and outcomes.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.