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DOI: 10.1055/s-0040-1704368
CLINICOPATHOLOGICAL CHARACTERIZATION AND SURVIVAL OUTCOME OF EARLY ONSET COLORECTAL CANCER IN THE LAST 30 YEARS IN THE NETHERLANDS
Publication History
Publication Date:
23 April 2020 (online)
Aims Colorectal cancer (CRC) incidence is increasing in young adults. Most of the early-onset CRC (EOCRC) are sporadic. Little is known about the clinicopathological characteristics of sporadic EOCRC. To identity features unique to EOCRC, we evaluated clinicopathological characteristics and survival outcome in EORCT patients in the Netherlands within the last 30 years.
Methods All patients diagnosed with CRC < 50 years of age between 1990-2018 and in the absence of Lynch syndrome were included. Patients were divided in 3 groups: group 1 (20-29 years old); group 2 (30-39 years old); group 3 (40-49 years old). Clinical characteristics included: gender, tumor location and presence of metastasis. Pathological characteristics included: tumor type, differentiation grade, invasion depth and presence of lymph node. Chi-square tests and Log rank tests were performed.
Results 6.632 CRC patients were included; group 1: 209 (3%) patients, group 2: 1255 (19%) patients, group 3: 5168 (78%) patients. No difference in sex was observed between the groups. Group 1 had the highest occurrence of colon carcinomas (69.2% vs. 61.9% and 61.2% in group 2 (p=0.049) and 3 (p=0.022)). Group 1 and 2 showed higher occurrence of signet ring-cell carcinoma (5.3% and 3.6% vs. 1.3%, p< 0.001), CRC was more often poorly differentiated (21.5% and 15.2% vs. 12.8%, p=0.001) and more often positive lymph nodes were present (16.2% and 9.8% vs. 7.8%, p=0.000) versus group 3. Group 3 had the highest occurrence of adenocarcinoma (75.0% vs. 68.7% and 66.0% in group 2 and 1, p< 0.001). No difference was found in presence of metastasis. Overall survival rates were 59.8% (group 1), 62.4% (group 2), 63.4% (group 3) (p=0.788).
Conclusions Poor prognosis pathological features of CRC are more prevalent in (non-Lynch syndrome) early onset CRC compared to older ages. This did not affect overall survival of the youngest patients compared to the 30-49 year olds.