Patients with early-onset rectal cancer aged 40 year or less have similar oncologic outcomes to older patients despite presenting in more advanced stage; A retrospective cohort study

Emile, Sameh Hany; Elfeki, Hossam; Shalaby, Mostafa; Elbalka, Saleh S.; Metwally, Islam H.; Abdelkhalek, Mohamed

doi:10.1016/j.ijsu.2020.09.029

Cited by 13 publications

(8 citation statements)

References 32 publications

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“…Higher local recurrence might be also attributed to the younger age of patients in our study as the mean age was 47 years. Such young‐onset rectal cancer has been previously reported by our group and other investigators from Egypt 30,31 . While the explanation of this young onset of rectal cancer in our country is unclear and needs to be thoroughly studied, it may contribute to a worse outcome and higher recurrence after curative surgery for CRC 32,33 …”

Section: Discussionmentioning

confidence: 51%

“…Such young-onset rectal cancer has been previously reported by our group and other investigators from Egypt. 30,31 While the explanation of this young onset of rectal cancer in our country is unclear and needs to be thoroughly studied, it may contribute to a worse outcome and higher recurrence after curative surgery for CRC. 32,33 The higher local recurrence reported in our study may affect the accuracy of the PREDICT score when applied to other cohorts with lower rates of local recurrence.…”

Section: Diagnostic Accuracy Of the Predict Score In Prediction Of Lo...mentioning

confidence: 99%

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Multicenter validation of the PREDICT score for prediction of local recurrence after total mesorectal excision of rectal cancer

Emile

Madbouly

Elfeki

et al. 2022

Journal of Surgical Oncology

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Background Total mesorectal excision (TME) is the gold standard treatment for rectal cancer. Although TME has managed to decrease the rates of local recurrence after rectal cancer resection, local recurrence is still recorded at varying rates. The present study aimed to validate the PREDICT score in the prediction of local recurrence of rectal cancer after TME with curative intent. Methods This was a retrospective multicenter study on patients with nonmetastatic low or middle rectal cancer who underwent TME. The total PREDICT score was calculated for every patient and related to the onset of local recurrence. According to the final score, patients were allocated to one of three risk groups: low, moderate, and high, and the rates of local recurrence in each group were calculated and compared. Results The present study included 262 patients (50.4% males) with a mean age of 47.1 years. The overall local recurrence rate was 12.6%. 29.4% of patients were in the low‐risk group, 63.7% in the moderate‐risk group, and 6.9% in the high‐risk group. The local recurrence rate was 3.9% (95% confidence interval [CI]: 0.8–10.9) in the low‐risk group, 13.2% (95% CI: 8.4–19.3) in the moderate risk group, and 44.4% (95% CI: 21.5–69.2) in the high‐risk group (p < 0.0001). The sensitivity of the PREDICT score was 72.7%, the specificity was 88.1%, and the accuracy was 86.3%. Conclusions The PREDICT score had good diagnostic accuracy in the prediction of local recurrence after TME and a good discriminatory ability in the differentiation between patients at different risks to develop local recurrence.

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Section: Discussionmentioning

confidence: 51%

Section: Diagnostic Accuracy Of the Predict Score In Prediction Of Lo...mentioning

confidence: 99%

Multicenter validation of the PREDICT score for prediction of local recurrence after total mesorectal excision of rectal cancer

Emile

Madbouly

Elfeki

et al. 2022

Journal of Surgical Oncology

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“…Some authors believe that cancer in elderly patients may be biologically less aggressive [22,23]. Therefore, the younger patients with cancer are thought to have a worse prognosis than the older patients [24][25][26][27]. Tang et al [2] conducted a comparative study of adolescents and young adults after radical resection of pancreatic ductal adenocarcinoma by propensity score matching and concluded that pancreatic ductal adenocarcinoma may be more aggressive in adolescents and young adults.…”

Section: Discussionmentioning

confidence: 99%

Robotic pancreaticoduodenectomy in the young

Shyr,

Shih,

Wang

et al. 2023

Preprint

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Pancreaticoduodenectomy is rarely performed in young patients, and the impact of age on surgical and survival outcomes after robotic pancreaticoduodenectomy has not been extensively studied. This study aimed to evaluate the surgical and survival outcomes of patients aged < 50 years who underwent robotic pancreaticoduodenectomy. A comparative study was conducted on patients who underwent robotic pancreaticoduodenectomy divided into two groups: young (age, < 50 years) and old (age, ≥ 50 years). A total of 555 patients were included in this study, with 53 (9.5%) in the young group and 502 (90.5%) in the old group. Periampullary adenocarcinomas were less common in the young group (32.1% vs. 76.5%), whereas solid and pseudopapillary tumors (9.4% vs. 1.0%) and neuroendocrine tumors (15.1% vs. 3.6%) were more common. Soft pancreatic parenchyma (77.4% vs. 62.5%) and non-dilated (≤ 3 mm) pancreatic ducts (77.4% vs. 46.3%) were more prevalent in the young group. The young group had a shorter length of stay (median, 16 vs. 20 days). There were no significant differences in the other surgical outcomes and risks. Survival outcomes for overall periampullary adenocarcinoma favored the young group, with a 5-year survival rate of 76.4% vs. 46.7% in the old group. Robotic pancreaticoduodenectomy in the young patients (< 50 years) is associated with comparable surgical outcomes and favorable survival outcomes for periampullary adenocarcinoma compared with the older patients (≥ 50 years). These findings highlight the feasibility and safety of robotic pancreaticoduodenectomy in the young population.

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“…Several studies have shown poor survival outcomes due to a higher proportion of progressive tumours, 46 , 47 whereas others have reported a better prognosis than later‐onset patients. 40 , 42 , 48 However, previous studies have certain limitations, such as inconsistent definitions of EOCRC or LOCRC, 49 , 50 , 51 studies only on patients with progressive tumours, 52 , 53 and insufficient study inclusion for prognostic analysis (fewer than 100 cases), 17 , 54 which do not allow for the exposure of actual prognostic differences between the two age groups. Our study found no differences in 5‐year CSS, consistent with the results of several large‐scale retrospective studies in recent years, 20 , 55 and similar results were obtained for metastatic CRC.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the short‐ and long‐term prognosis of early‐onset colorectal cancer compared with later‐onset colorectal cancer: A systematic review and meta‐analysis

Jin

et al. 2023

Health Science Reports

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Background and Aims: The annual incidence of early-onset colorectal cancer (EOCRC) is increasing at an alarming rate. The prognosis of EOCRC remains controversial, and whether the early onset is a risk factor for colorectal cancer remains unclear.Methods: We searched four electronic bibliographic databases from database inception to April 25, 2022 for studies that included both early-and later-onset patients and performed a prognostic analysis. Random-effects models were used to summarize the prognostic information extracted by the investigators, including overall survival (OS), cancer-special survival (CSS), and disease-free survival (DFS).Network meta-analysis (NMA) was used to compare patients' long-term prognoses in different age subgroups.Results: After 694 reports were screened, 13 studies were included in the final analysis, with a total of 448,781 CRC cases. In the meta-analysis of the 5-year OS, EOCRC had a better prognosis compared to LOCRC (hazard ratio [HR] 0.87, 95% confidence interval [CI], 0.74-0.99; relative risk [RR] 0.83, 95% CI, 0.78-0.89). No difference in prognosis was found between the two groups in terms of 5-year CSS (RR 0.99, 95% CI, 0.93-1.05), 5-year DFS (RR 0.90, 95% CI, 0.74-1.09), and shortterm OS. In the NMA, patients aged <30 years had the worst outcome (surface under the cumulative ranking curve [SUCRA], 15.8%) in 5-year OS; consistent results were observed in the analysis of 5-year CSS (<30 years, SUCRA 4.5%), but the difference was not statistically significant. Conclusion:Although patients with early-onset CRC had better OS than those with later-onset CRC, there was no difference in the CSS. Meanwhile, the trend for survival was worse in younger patients, especially in those ages 18-29 years. Thus, more attention should be paid to early diagnosis and treatment of EOCRC.

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Patients with early-onset rectal cancer aged 40 year or less have similar oncologic outcomes to older patients despite presenting in more advanced stage; A retrospective cohort study

Cited by 13 publications

References 32 publications

Multicenter validation of the PREDICT score for prediction of local recurrence after total mesorectal excision of rectal cancer

Multicenter validation of the PREDICT score for prediction of local recurrence after total mesorectal excision of rectal cancer

Robotic pancreaticoduodenectomy in the young

Comparison of the short‐ and long‐term prognosis of early‐onset colorectal cancer compared with later‐onset colorectal cancer: A systematic review and meta‐analysis

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