Korean J Clin Oncol.  2016 Dec;12(2):67-72. 10.14216/kjco.16011.

Clinicopathologic characteristics of patients with sporadic colorectal cancer under the age of 30

Affiliations
  • 1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hckimcrc@gmail.com

Abstract

PURPOSE
The purpose of this study was to investigate the distinctive clinicopathologic features and oncological survival outcomes of sporadic colorectal cancer in patients under the age of 30 years old.
METHODS
From 1994 to 2013, total 15,206 patients underwent curative or palliative surgery for sporadic colorectal cancer in our institution. 235 patients (1.5%) were under 30 years of age. Patients who presented with metachronous cancers, recurrent cancers, hereditary nonpolyposis colorectal cancer, familial adenomatous polyposis and patients without a microsatellite instability (MSI) analysis were excluded. A total 79 pateints who were ≤30 years old with sporadic colorectal cancer were enrolled.
RESULTS
Seven patients (8.9%) had family history of colorectal cancer. Location of the tumor was 23 (29.1%) in right colon, 29 (36.7%) in left colon, 27 (34.2%) in rectum. Young patients tend to present with a higher incidence of mucinous and signet ring cell tumors (15.2%), poorly differentiated tumors (11.4%) and advanced stage such as Stage III (31.6%), Stage IV (30.4%). microsatellite instability-high (MSI-H) was observed in 10 (12.7%), microsatellite stable (MSS)/ microsatellite instability-low (MSI-L) in 69 (87.3%). 66.7% (n=6) of the MSI-H tumors showed loss of hMLH1 expression; no MSS/MSI-L tumors showed hMLH1 loss. 5 years ovarall survival was 72.8%. Stage specific overall survival was 100% for stage I, 100% for stage II, 75.9% for stage III, 31.4% for stage IV.
CONCLUSION
Patients with sporadic colorectal cancer under the age of 30 seem to have poor outcome than older patients, because of characteristic clinical and biological behaviors. Early detection of colorectal cancer (CRC) confers survival benefit to young patients.

Keyword

Colorectal cancer; Sporadic; Early onset; Less than 30 years old; Prognosis

MeSH Terms

Adenomatous Polyposis Coli
Colon
Colorectal Neoplasms*
Colorectal Neoplasms, Hereditary Nonpolyposis
Humans
Incidence
Microsatellite Instability
Microsatellite Repeats
Mucins
Palliative Care
Prognosis
Rectum
Mucins
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