Citation Information :
Aday U, Kafadar MT, Oğuz A, Bahadır MV, Demir B, Akpulat FV, Gulturk B, Böyük A. Polyposis and Oncologic Outcomes in Young-onset Sporadic Colorectal Cancer. Euroasian J Hepatogastroenterol 2021; 11 (1):6-10.
Aim: The present study aimed to investigate the effect of the presence of polyposis in sporadic early-onset colorectal cancer (EOCRC) on clinicopathological and oncological outcomes.
Methods: The retrospective study included patients with sporadic colorectal cancer aged 16 to 50 years who underwent curative resection at the general surgery clinics in two healthcare centers between 2013 and 2019. Patients were divided into two groups: polyposis and nonpolyposis. Clinicopathological characteristics and oncological outcomes were compared between the two groups.
Results: A total of 127 patients were included, of whom 60.6% were men. There were 25 (19.68%) patients in the polyposis group and 102 (80.31%) patients in the nonpolyposis group. Seventy-one (69.6%) of the nonpolyposis group and 23 (92.0%) of the polyposis group had adenocarcinoma histological types. The total number of patients with mucinous tumor and signet ring cell carcinoma in the nonpolyposis and polyposis groups was 31 (30.4%) and 2 (8.0%), respectively (p = 0.042). Five-year overall survival (OS) was 60 and 72% in the nonpolyposis and polyposis groups, respectively, and no significant difference was found (p = 0.332). In univariate analysis, American Joint Committee on Cancer (AJCC) tumor stage (pT) ≥3–4, lymph node positivity, presence of mucinous tumor and signet ring cell carcinoma, lymphovascular invasion, and advanced tumor-lymph nodesmetastasis (TNM) stage (III–IV) were found to be significant negative prognostic factors for OS, whereas none of these parameters were found to be prognostic factors in multivariate analysis. The presence of polyposis was not a significant factor on both univariate and multivariate analyses.
Conclusion: Although the sporadic EOCRC cases developing on the basis of polyposis can have slightly better oncological outcomes, these outcomes are mostly similar to those of cases with nonpolyposis.
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394–424. DOI: 10.3322/caac.21492.
Siegel RL, Torre LA, Soerjomataram I, et al. Global patterns and trends in colorectal cancer incidence in young adults. Gut 2019;68(12):2179–2185. DOI: 10.1136/gutjnl-2019-319511.
Bailey CE, Hu CY, You YN, et al. Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975–2010. JAMA Surg 2015;150(1):17–22. DOI: 10.1001/jamasurg.2014.1756.
Dekker E, Tanis PJ, Vleugels JLA, et al. Colorectal cancer. Lancet 2019;394(10207):1467–1480. DOI: 10.1016/S0140-6736(19)32319-0.
Bleyer A. CAUTION! Consider cancer: common symptoms and signs for early detection of cancer in young adults. Semin Oncol 2009;36(3):207–212. DOI: 10.1053/j.seminoncol.2009.03.004.
You YN, Xing Y, Feig BW, et al. Young-onset colorectal cancer: is it time to pay attention? Arch Intern Med 2012;172(3):287–289. DOI: 10.1001/archinternmed.2011.602.
Ciarrocchi A, Amicucci G. Sporadic carcinoma of the colon-rectum in young patients: a distinct disease? A critical review. J Gastrointest Cancer 2013;44(3):264–269. DOI: 10.1007/s12029-013-9507-5.
Mallinson EK, Newton KF, Bowen J, et al. The impact of screening and genetic registration on mortality and colorectal cancer incidence in familial adenomatous polyposis. Gut 2010;59(10):1378–1382. DOI: 10.1136/gut.2010.212449.
Babaya A, Yamano T, Matsubara T, et al. Long-term clinical outcomes and follow-up status in Japanese patients with familial adenomatous polyposis after radical surgery: a descriptive, retrospective cohort study from a single institute. Int J Colorectal Dis 2020;35(4):675–684. DOI: 10.1007/s00384-020-03524-y.
Myrhøj T, Bisgaard ML, Bernstein I, et al. Hereditary non-polyposis colorectal cancer: clinical features and survival. Results from the Danish HNPCC register. Scand J Gastroenterol 1997;32(6):572–576. DOI: 10.3109/00365529709025102.
Edge SB, Byrd DR, Compton CC, et al. AJCC cancer staging handbook. 7th ed. New York: Springer; 2010.
Vuik FE, Nieuwenburg SA, Bardou M, et al. Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years. Gut 2019;68(10):1820–1826. DOI: 10.1136/gutjnl-2018-317592.
Troeung L, Sodhi-Berry N, Martini A, et al. Increasing incidence of colorectal cancer in adolescents and young adults aged 15-39 years in Western Australia 1982–2007: examination of colonoscopy history. Front Public Health 2017;5:179. DOI: 10.3389/fpubh.2017.00179.
Deng Y. Rectal cancer in Asian vs. Western countries: why the variation in incidence? Curr Treat Options Oncol 2017;18(10):64. DOI: 10.1007/s11864-017-0500-2.
Saad El Din K, Loree JM, Sayre EC, et al. Trends in the epidemiology of young-onset colorectal cancer: a worldwide systematic review. BMC Cancer 2020;20(1):288. DOI: 10.1186/s12885-020-06766-9.
Karahalios A, English DR, Simpson JA. Weight change and risk of colorectal cancer: a systematic review and meta-analysis. Am J Epidemiol 2015;181(11):832–845. DOI: 10.1093/aje/kwu357.
Jasperson KW, Tuohy TM, Neklason DW, et al. Hereditary and familial colon cancer. Gastroenterology 2010;138(6):2044–2058. DOI: 10.1053/j.gastro.2010.01.054.
Boardman LA, Vilar E, You YN, et al. AGA clinical practice update on young adult-onset colorectal cancer diagnosis and management: expert review. Clin Gastroenterol Hepatol 2020;18(11):2415–2424. DOI: 10.1016/j.cgh.2020.05.058.
Dozois EJ, Boardman LA, Suwanthanma W, et al. Young-onset colorectal cancer in patients with no known genetic predisposition: can we increase early recognition and improve outcome? Medicine (Baltimore) 2008;87(5):259–263. DOI: 10.1097/MD.0b013e3181881354.
Chen FW, Sundaram V, Chew TA, et al. Advanced-stage colorectal cancer in persons younger than 50 years not associated with longer duration of symptoms or time to diagnosis. Clin Gastroenterol Hepatol 2017;15(5):728–737. DOI: 10.1016/j.cgh.2016.10.038.
O'Connell JB, Maggard MA, Livingston EH, et al. Colorectal cancer in the young. Am J Surg 2004;187(3):343–348. DOI: 10.1016/j.amjsurg.2003.12.020.
Myers EA, Feingold DL, Forde KA, et al. Colorectal cancer in patients under 50 years of age: a retrospective analysis of two institutions’ experience. World J Gastroenterol 2013;19(34):5651–5657. DOI: 10.3748/wjg.v19.i34.5651.
Bertario L, Russo A, Sala P, et al. Survival of patients with hereditary colorectal cancer: comparison of HNPCC and colorectal cancer in FAP patients with sporadic colorectal cancer. Int J Cancer 1999;80(2):183–187. DOI: 10.1002/(sici)1097-0215(19990118)80:2<183::aid-ijc4>3.0.co;2-w.
Haghighi MM, Vahedi M, Mohebbi SR, et al. Comparison of survival between patients with hereditary non polyposis colorectal cancer (HNPCC) and sporadic colorectal cancer. Asian Pac J Cancer Prev 2009;10(2):209–212.
Aarnio M, Mustonen H, Mecklin JP, et al. Prognosis of colorectal cancer varies in different high-risk conditions. Ann Med 1998;30(1):75–80. DOI: 10.3109/07853899808999387.
Brixen LM, Bernstein IT, Bülow S, et al. Survival of patients with Stage III colon cancer is improved in hereditary non-polyposis colorectal cancer compared with sporadic cases. A Danish registry based study. Colorectal Dis 2013;15(7):816–823. DOI: 10.1111/codi.12150.
Dolan S. Familial adenomatous polyposis: development, presentation, and treatment strategies. Clin J Oncol Nurs 2019;23(2):135–138. DOI: 10.1188/19.CJON.135-138.