Seminars in Colon and Rectal Surgery最新文献

Epidemiology, molecular biology, and genetics of sporadic young onset colorectal cancer 散发性青年结直肠癌的流行病学、分子生物学和遗传学

IF 0.5

Seminars in Colon and Rectal Surgery Pub Date : 2025-07-23 DOI: 10.1016/j.scrs.2025.101122

Yasamin Taghikhan MD, Sean Flynn MD

{"title":"Epidemiology, molecular biology, and genetics of sporadic young onset colorectal cancer","authors":"Yasamin Taghikhan MD, Sean Flynn MD","doi":"10.1016/j.scrs.2025.101122","DOIUrl":"10.1016/j.scrs.2025.101122","url":null,"abstract":"<div><div>The incidence of colorectal cancer (CRC) in individuals under 50 years of age—termed young-onset colorectal cancer (YOCRC)—has been increasing despite declining rates of CRC overall. YOCRC now comprises up to 15 % of new CRC diagnoses. Most cases of YOCRC are sporadic, occurring without identifiable hereditary syndromes or family history. It exhibits distinct epidemiological and molecular characteristics, including a predilection for rectal and left-sided tumors, aggressive histology, and more advanced stage at diagnosis. Suspected risk factors contributing to this rising incidence are multifactorial and include lifestyle and environmental exposures, such as westernized diets, obesity, sedentary behavior, increased antibiotic exposure, and chronic inflammation. These factors interact with the gut microbiome to induce dysbiosis, pro-inflammatory states, and DNA damage. At the molecular level, YOCRC is most associated with chromosomal instability (CIN), while a minority exhibit microsatellite instability (MSI) or CpG island methylator phenotype (CIMP). Compared to late-onset CRC, YOCRC displays lower rates of KRAS, BRAF, and APC mutations, but increased TP53 and PTEN alterations. Emerging research also highlights differences in the tumor microenvironment, including immune cell infiltration and complement expression, which may influence therapeutic response. Understanding the unique biology of sporadic YOCRC is essential for developing risk stratification models, refining screening strategies, and advancing targeted treatment approaches. Continued investigation into genetic susceptibility, environmental triggers, and tumor immunobiology will be crucial in addressing this evolving public health challenge.</div></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"36 3","pages":"Article 101122"},"PeriodicalIF":0.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Young onset colorectal cancer in hereditary syndromes 年轻发病的结直肠癌的遗传综合征

IF 0.5

Seminars in Colon and Rectal Surgery Pub Date : 2025-07-22 DOI: 10.1016/j.scrs.2025.101121

Thomas A. Sorrentino , B. Mark Zhao

引用次数: 0

Global perspectives on young-onset colorectal cancer: epidemiology, challenges, and advances 年轻发病结直肠癌的全球视角：流行病学、挑战和进展

IF 0.5

Seminars in Colon and Rectal Surgery Pub Date : 2025-07-22 DOI: 10.1016/j.scrs.2025.101118

Drew Goldberg , Erica Pettke

{"title":"Global perspectives on young-onset colorectal cancer: epidemiology, challenges, and advances","authors":"Drew Goldberg , Erica Pettke","doi":"10.1016/j.scrs.2025.101118","DOIUrl":"10.1016/j.scrs.2025.101118","url":null,"abstract":"<div><div>Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide. It is thought to mainly affect older populations, typically considered those aged 50 or above. Recent trends have shown that CRC in patients younger than 50 years old, known as early onset colorectal cancer (EOCRC), is on the rise while rates of disease in older populations have leveled off or even decreased in many places. This alarming trend is described globally, with a clear relationship between highly developed nations and EOCRC disease burden. More granular disease drivers remain elusive but have been linked to diet, lifestyle, genetic predispositions, and environmental exposure. The clinical, genetic, and histological characteristics of EOCRC imply it is a separate oncologic entity from CRC within older populations. Challenges in management of global EOCRC include standardized clinical guidance, diagnostic consensus, and treatment strategies. Advancements in care have allowed for improved public awareness and disease risk prediction. The pattern of global EOCRC trends represents a significant population health concern, and as such deserves increased attention from clinicians, patients, and the public alike.</div></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"36 3","pages":"Article 101118"},"PeriodicalIF":0.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Watch and wait in early onset rectal cancer patients: A review of the literature 观察和等待早发直肠癌患者：文献综述

IF 0.5

Seminars in Colon and Rectal Surgery Pub Date : 2025-07-03 DOI: 10.1016/j.scrs.2025.101117

Melissa K Drezdzon , Carrie Y Peterson

{"title":"Watch and wait in early onset rectal cancer patients: A review of the literature","authors":"Melissa K Drezdzon , Carrie Y Peterson","doi":"10.1016/j.scrs.2025.101117","DOIUrl":"10.1016/j.scrs.2025.101117","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the general decline in rectal cancer<span> diagnoses, early onset rectal cancer (EORC) diagnoses are increasing. Meanwhile, Watch and Wait (WW) surveillance for patients with complete clinical response to neoadjuvant therapy is gaining popularity. While outcomes for WW are good, there may be hesitancy enrolling younger patients. This review aimed to evaluate literature examining WW in EORC patients.</span></div></div><div><h3>Methods</h3><div><span>A systematic literature review was conducted and full-text, peer-reviewed manuscripts were assessed for eligibility. A single study, “</span><em>Watch and Wait After a Clinical Complete Response in Rectal Cancer Patients Younger than 50 Years,”</em> by Bahadoer et al. (2021) was identified.</div></div><div><h3>Results</h3><div>The study included 199 EORC patients followed for a mean of 3.2 years. Compared to older patients, EORC patients had higher overall survival, and similar rates of disease-free survival and local recurrence.</div></div><div><h3>Discussion</h3><div>The results of the identified study are encouraging, however, there is a paucity of data on WW in EORC patients, including not only clinical outcomes but surveillance compliance and barriers that might inform treatment decision-making. Decisions regarding WW in EORC patients should be made on an individual case after thorough discussion with patients.</div></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"36 3","pages":"Article 101117"},"PeriodicalIF":0.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fertility considerations young onset CRC 生育方面的考虑，早发性结直肠癌

IF 0.5

Seminars in Colon and Rectal Surgery Pub Date : 2025-07-03 DOI: 10.1016/j.scrs.2025.101119

Jared Matson MD, Shanglei Liu MD MAS

{"title":"Fertility considerations young onset CRC","authors":"Jared Matson MD, Shanglei Liu MD MAS","doi":"10.1016/j.scrs.2025.101119","DOIUrl":"10.1016/j.scrs.2025.101119","url":null,"abstract":"<div><div>The incidence of young-onset colorectal cancer (YOCRC) is rising. This patient population often presents with advanced disease and is treated more aggressively, raising unique challenges—particularly regarding fertility and sexual function. This chapter explores the multifaceted impact of YOCRC treatment on fertility and the importance of early reproductive counseling. YOCRC patients frequently undergo multimodal therapy, including chemotherapy, radiation, and surgery—all of which can impair fertility. Chemotherapeutic agents like oxaliplatin and irinotecan are known to be gonadotoxic, with variable long-term effects in both men and women. Pelvic radiation carries high risks for both gonadal failure and uterine or testicular dysfunction. Surgical interventions can damage reproductive organs or alter anatomical and hormonal function, leading to infertility. Fertility preservation methods—including sperm or oocyte cryopreservation, embryo freezing, ovarian transposition, and tissue cryopreservation—offer patients the possibility of future biological parenthood but require early intervention. Additionally, sexual dysfunction is common, driven by nerve damage, radiation effects, anatomical changes, and psychological distress, all of which may further impair reproductive potential. Given that YOCRC patients are often first evaluated by surgeons, it is critical for providers to discuss fertility and sexual health early and refer patients to reproductive specialists. Improved provider awareness and proactive counseling can help preserve future family-building options and enhance quality of life for this growing patient population.</div></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"36 3","pages":"Article 101119"},"PeriodicalIF":0.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Young-onset colorectal cancer quality of life and psychosocial concerns 年轻发病结直肠癌的生活质量和社会心理问题

IF 0.5

Seminars in Colon and Rectal Surgery Pub Date : 2025-07-03 DOI: 10.1016/j.scrs.2025.101120

Jaewon J Lee, Kristen E Dougherty, Karyn B Stitzenberg

引用次数: 0

Sponsorship, mentorship, and coaching: Navigating the path to surgical leadership 赞助、指导和指导：引导外科领导之路

IF 0.4

Seminars in Colon and Rectal Surgery Pub Date : 2025-03-21 DOI: 10.1016/j.scrs.2025.101103

Sharon L. Stein MD

引用次数: 0

The path to career advancement in surgical research 外科研究的职业发展之路

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Seminars in Colon and Rectal Surgery Pub Date : 2025-03-20 DOI: 10.1016/j.scrs.2025.101104

Erin Wolf Horrell MD, PhD , Alexander T Hawkins MD, MPH

引用次数: 0

The role of surgical societies in surgical leadership and career development 外科学会在外科领导和职业发展中的作用

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Seminars in Colon and Rectal Surgery Pub Date : 2025-03-20 DOI: 10.1016/j.scrs.2025.101107

Sean J. Langenfeld MD

引用次数: 0

From OR to boardroom: Transferring surgical skills to executive leadership roles 从手术室到会议室：将外科技能转化为行政领导角色

IF 0.4

Seminars in Colon and Rectal Surgery Pub Date : 2025-03-20 DOI: 10.1016/j.scrs.2025.101100

Walter R. Peters Jr. MD, MBA

引用次数: 0