Post-operative and short-term oncological outcomes in patients with early-onset colorectal cancer: A prospective observational study

Abstract

Background

In recent years the incidence of early-onset colorectal cancer (EOCRC) has increased. This disease entity presents with a different clinical and pathological pattern, unlike late-onset colorectal cancer (LOCRC).

Materials and methods

117 patients with colorectal cancer were included and divided into EOCRC (≤45 years) and LOCRC (>45 years) from July 2022 to Dec 2023. Descriptive statistics were used for data presentation. Mann-Whitney test was used for skewed data. Frequencies and proportions were used to characterize categorical variables. Fisher's Exact Test or Chi-square was used to compare the proportions.

Results

37(31.6%) were EOCRC, and 80(68.4%) were LOCRC. EOCRC patients presented more frequently with stage III disease 15(48.4%) vs LOCRC 29(42%) (p ​= ​0.288). Majority were left-sided tumors 26(70.2%) in EOCRC vs 55(68.8%) in LOCRC, and rectum was involved in 18(48.6%) vs 39(48.8%) respectively. Poorly differentiated cancer was more common in five (19.2%) vs five (10.4%) in both groups (p ​= ​0.538). Signet ring cell morphology and mucin positivity respectively were significantly higher in the EOCRC group nine (32.1%) vs three (5.6%) in the LOCRC (p ​= ​0.0023), EOCRC group 18(66.7%) vs LOCRC 18(33.3%) (p ​= ​0.0042). Overall, there were seven (6.3%) 30-day perioperative mortalities three (8.3%) in EOCRC, and four (5.3%) in the LOCRC group (p ​= ​0.68). 30-day perioperative complications are more common in the LOCRC group (p ​= ​0.0192).

Conclusion

Clinical outcomes, in the form of post-operative morbidity and length of stay, were significantly lower among the younger group of patients. However, high rates of advanced-stage, poorly differentiated, and mucin-secreting tumor patients were seen in the younger age group.