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Colorectal cancer of the young displays distinct features of aggressive tumor biology: A single-center cohort study
BACKGROUND: In recent years, a decrease in incidence and mortality of colorectal cancer (CRC) has been observed in developed nations, presumably through public disease awareness and increased screening efforts. However, a rising incidence of CRC in young patients below the age of 50 years has been r...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898186/ https://www.ncbi.nlm.nih.gov/pubmed/33643536 http://dx.doi.org/10.4240/wjgs.v13.i2.164 |
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author | Mueller, Matteo Schneider, Marcel André Deplazes, Barla Cabalzar-Wondberg, Daniela Rickenbacher, Andreas Turina, Matthias |
author_facet | Mueller, Matteo Schneider, Marcel André Deplazes, Barla Cabalzar-Wondberg, Daniela Rickenbacher, Andreas Turina, Matthias |
author_sort | Mueller, Matteo |
collection | PubMed |
description | BACKGROUND: In recent years, a decrease in incidence and mortality of colorectal cancer (CRC) has been observed in developed nations, presumably through public disease awareness and increased screening efforts. However, a rising incidence of CRC in young patients below the age of 50 years has been reported in several studies. AIM: To study tumor biology in CRC patients below 50 years of age. METHODS: All patients with CRC were prospectively enrolled in our single-center oncologic database from January 2013 to December 2018 and were grouped and analyzed according to age (≥ 50 and < 50 years). Clinical as well as histopathological features were analyzed and compared. The study was approved by the local Ethics Committee. Fisher’s exact test or t-test was used to test for differences between the groups, as appropriate. All statistical analysis was performed with IBM SPSS software Version 25 (SPSS Inc, Armonk, NY, United States) and with R-Studio using R Version 3.4.1 (RStudio, Boston, MA, United States). RESULTS: Seventeen percent of the 411 patients were younger than 50 years. Young patients were more often diagnosed with locally advanced T4-tumors and lymph node metastases (36.6% and 62% vs 17.7% and 42%; P < 0.01). In addition, a higher frequency of poorly differentiated (G3) tumors (40% vs 22.4% P < 0.05) was observed. More than every second patient below 40 years of age (51.8%) had distant metastases at diagnosis with a significant higher rate ring of signet cell differentiation compared to patients ≥ 50 years (14.8%, P < 0.05). Mutational status (KRAS, NRAS, BRAF, MSI) as well as selected behavioral risk factors showed no significant differences. CONCLUSION: Distinct histopathologic features of increased biologic aggressiveness are found in patients with CRC of young-onset. Those patients present more frequently with more advanced tumor stages compared to older patients. Features of aggressive tumor biology underscore the need for earlier uptake of routine screening measures. |
format | Online Article Text |
id | pubmed-7898186 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-78981862021-02-27 Colorectal cancer of the young displays distinct features of aggressive tumor biology: A single-center cohort study Mueller, Matteo Schneider, Marcel André Deplazes, Barla Cabalzar-Wondberg, Daniela Rickenbacher, Andreas Turina, Matthias World J Gastrointest Surg Retrospective Cohort Study BACKGROUND: In recent years, a decrease in incidence and mortality of colorectal cancer (CRC) has been observed in developed nations, presumably through public disease awareness and increased screening efforts. However, a rising incidence of CRC in young patients below the age of 50 years has been reported in several studies. AIM: To study tumor biology in CRC patients below 50 years of age. METHODS: All patients with CRC were prospectively enrolled in our single-center oncologic database from January 2013 to December 2018 and were grouped and analyzed according to age (≥ 50 and < 50 years). Clinical as well as histopathological features were analyzed and compared. The study was approved by the local Ethics Committee. Fisher’s exact test or t-test was used to test for differences between the groups, as appropriate. All statistical analysis was performed with IBM SPSS software Version 25 (SPSS Inc, Armonk, NY, United States) and with R-Studio using R Version 3.4.1 (RStudio, Boston, MA, United States). RESULTS: Seventeen percent of the 411 patients were younger than 50 years. Young patients were more often diagnosed with locally advanced T4-tumors and lymph node metastases (36.6% and 62% vs 17.7% and 42%; P < 0.01). In addition, a higher frequency of poorly differentiated (G3) tumors (40% vs 22.4% P < 0.05) was observed. More than every second patient below 40 years of age (51.8%) had distant metastases at diagnosis with a significant higher rate ring of signet cell differentiation compared to patients ≥ 50 years (14.8%, P < 0.05). Mutational status (KRAS, NRAS, BRAF, MSI) as well as selected behavioral risk factors showed no significant differences. CONCLUSION: Distinct histopathologic features of increased biologic aggressiveness are found in patients with CRC of young-onset. Those patients present more frequently with more advanced tumor stages compared to older patients. Features of aggressive tumor biology underscore the need for earlier uptake of routine screening measures. Baishideng Publishing Group Inc 2021-02-27 2021-02-27 /pmc/articles/PMC7898186/ /pubmed/33643536 http://dx.doi.org/10.4240/wjgs.v13.i2.164 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/ |
spellingShingle | Retrospective Cohort Study Mueller, Matteo Schneider, Marcel André Deplazes, Barla Cabalzar-Wondberg, Daniela Rickenbacher, Andreas Turina, Matthias Colorectal cancer of the young displays distinct features of aggressive tumor biology: A single-center cohort study |
title | Colorectal cancer of the young displays distinct features of aggressive tumor biology: A single-center cohort study |
title_full | Colorectal cancer of the young displays distinct features of aggressive tumor biology: A single-center cohort study |
title_fullStr | Colorectal cancer of the young displays distinct features of aggressive tumor biology: A single-center cohort study |
title_full_unstemmed | Colorectal cancer of the young displays distinct features of aggressive tumor biology: A single-center cohort study |
title_short | Colorectal cancer of the young displays distinct features of aggressive tumor biology: A single-center cohort study |
title_sort | colorectal cancer of the young displays distinct features of aggressive tumor biology: a single-center cohort study |
topic | Retrospective Cohort Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898186/ https://www.ncbi.nlm.nih.gov/pubmed/33643536 http://dx.doi.org/10.4240/wjgs.v13.i2.164 |
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