Is early-onset colorectal cancer an evolving pandemic? Real-world data from a tertiary cancer center.

IF 4.8 2区医学 Q1 ONCOLOGY

Oncologist Pub Date : 2024-12-06 DOI:10.1093/oncolo/oyae239

Angelos Angelakas, Thekla Christodoulou, Konstantinos Kamposioras, Jorge Barriuso, Michael Braun, Jurjees Hasan, Kalena Marti, Vivek Misra, Saifee Mullamitha, Mark Saunders, Natalie Cook

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引用次数: 0

Abstract

Background: Early onset Colorectal Cancer (EOCRC), defined as those diagnosed under the age of 50, has been increasing rapidly since 1970. UK data on EOCRC are currently limited and better understanding of the condition is needed.

Materials and methods: A single-center retrospective study of patients with EOCRC treated over 9 years (2013-2021) at a large UK cancer center was performed. Clinicopathological features, risk factors, molecular drivers, treatment, and survival were analyzed.

Results: In total, 203 patients were included. A significant increase in cases was reported from 2018-2019 (n = 33) to 2020-2021 (n = 118). Sporadic EOCRC accounted for 70% of cases and left-sided tumors represented 70.9% (n = 144). Median duration of symptoms was 3 months, while 52.7% of the patients had de-novo metastatic disease. Progression-free survival after first-line chemotherapy was 6 months (95% CI, 4.85-7.15) and median overall survival (OS) was 38 months (95% CI, 32.86-43.14). In the advanced setting, left-sided primary tumors were associated with a median OS benefit of 14 months over right-sided primaries (28 vs 14 months, P = .009). Finally, primary tumor resection was associated with median OS benefit of 21 months compared with in situ tumors (38 vs 17 months, P < .001).

Conclusions: The incidence of EOCRC is increasing, and survival outcomes remain modest. Raising public awareness and lowering the age for colorectal cancer screening are directions that could improve EOCRC clinical outcomes. There is also a need for large prospective studies to improve the understanding of the nature of EOCRC and the best therapeutic approaches.

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早发结直肠癌是一种不断演变的流行病吗？来自一家三级癌症中心的真实数据。

背景：早发结直肠癌（EOCRC）是指 50 岁以下确诊的患者，自 1970 年以来发病率迅速上升。目前，英国有关早发性结直肠癌的数据有限，因此需要更好地了解这种疾病：对英国一家大型癌症中心9年间（2013-2021年）收治的EOCRC患者进行了单中心回顾性研究。研究分析了临床病理特征、风险因素、分子驱动因素、治疗和生存情况：结果：共纳入 203 例患者。据报道，从2018-2019年（n=33）到2020-2021年（n=118），病例数明显增加。散发性EOCRC占70%，左侧肿瘤占70.9%（n = 144）。中位症状持续时间为3个月，52.7%的患者有新发转移性疾病。一线化疗后无进展生存期为6个月（95% CI，4.85-7.15），中位总生存期（OS）为38个月（95% CI，32.86-43.14）。在晚期治疗中，左侧原发肿瘤比右侧原发肿瘤的中位生存期延长14个月（28个月 vs 14个月，P = .009）。最后，与原位肿瘤相比，原位肿瘤切除的中位生存期延长了 21 个月（38 个月 vs 17 个月，P = 0.009）：EOCRC的发病率在不断上升，而生存率仍然不高。提高公众意识和降低结直肠癌筛查年龄是改善 EOCRC 临床结果的方向。此外，还需要开展大型前瞻性研究，以加深对 EOCRC 性质和最佳治疗方法的了解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncologist 医学-肿瘤学

CiteScore

10.40

自引率

3.40%

发文量

309

审稿时长

3-8 weeks

期刊介绍： The Oncologist® is dedicated to translating the latest research developments into the best multidimensional care for cancer patients. Thus, The Oncologist is committed to helping physicians excel in this ever-expanding environment through the publication of timely reviews, original studies, and commentaries on important developments. We believe that the practice of oncology requires both an understanding of a range of disciplines encompassing basic science related to cancer, translational research, and clinical practice, but also the socioeconomic and psychosocial factors that determine access to care and quality of life and function following cancer treatment.