Colorectal Cancer in the Young: Research in Early Age Colorectal Cancer Trends (REACCT) Collaborative
Abstract
:Simple Summary
Abstract
1. Introduction
2. Methods
2.1. Study Participants
2.2. Data Collection
2.3. Study Endpoints
2.4. Statistical Analysis
3. Results
3.1. Baseline Demographics
3.2. Clinical Characteristics
3.3. Neoadjuvant and Adjuvant Therapy
3.4. Pathology
3.5. Molecular Features
3.6. Oncological Outcomes
3.6.1. Colon Cancer
3.6.2. Rectal Cancer
3.7. Factors Influencing Survival
3.8. Impact of Neoadjuvant and Adjuvant Therapy on Survival
4. Discussion
5. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Colon N = 1884 | Rectal N = 1494 | |
---|---|---|
Median age (range) | 43 (18–49) | 43 (18–49) |
Male | 997 (52.9%) | 838 (56.1%) |
Median BMI (range) | 24 (13–59) | 23 (12–50) |
Inflammatory Bowel Disease | 67 (3.6%) | 42 (2.8%) |
First Degree Relative with CRC | 591 (31.4%) | 482 (32.3%) |
Known hereditary cancer syndrome | 0 (0%) | 0 (0%) |
Symptoms | ||
Abdominal pain | 580 (30.8%) | 174 (11.6%) |
Change in bowel habit | 393 (20.9%) | 380 (25.4%) |
Rectal bleeding | 535 (28.4%) | 873 (58.4%) |
Anaemia | 235 (12.5%) | 51 (3.4%) |
Incidental finding | 132 (7.0%) | 52 (3.5%) |
Other | 170 (9.0%) | 88 (5.9%) |
Tumor site | ||
Rectosigmoid junction | 202 (10.7%) | - |
Sigmoid colon | 674 (35.8%) | - |
Descending colon | 160 (8.5%) | - |
Splenic flexure | 121 (6.4%) | - |
Transverse | 191 (10.1%) | - |
Hepatic flexure | 58 (3.1%) | - |
Ascending colon | 252 (13.4%) | - |
Caecum | 239 (12.7%) | - |
Synchronous tumor | 13 (0.6%) | 14 (0.9%) |
Neoadjuvant therapy | 58 (3.0%) | 527 (35.3%) |
Type of neoadjuvant therapy | ||
Chemoradiotherapy | - | 434 (29.0%) |
Radiotherapy only | - | 59 (4.0%) |
Chemotherapy only | 58 (3.0%) | 34 (2.3%) |
pTNM stage | ||
I | 448 (23.8%) | 460 (30.8%) |
II | 626 (32.2%) | 411 (27.5%) |
III | 810 (43.0%) | 623 (41.7%) |
Stage I | Stage II | Stage III | |
---|---|---|---|
Rectal cancer | |||
Neoadjuvant (chemo)radiotherapy | 160 (34.8%) | 173 (42.1%) | 194 (31.1%) |
Adjuvant chemotherapy | 70 (15.2%) | 126 (30.7%) | 419 (67.3%) |
Colon cancer | |||
Adjuvant chemotherapy | 9 (2.0%) | 215 (34.3%) | 597 (73.7%) |
(a) | ||||||
---|---|---|---|---|---|---|
Univariable | Multivariable | |||||
Variable | HR | 95% CI | p | HR | 95% CI | p |
Age (years) | 1.007 | 0.986, 1.028 | 0.522 | - | - | - |
Male | 0.750 | 0.567, 0.989 | 0.041 | - | - | - |
cTNM stage I–II | 2.524 | 1.717, 3.710 | <0.0001 | - | - | - |
cTNM stage III | 0.396 | 0.270, 0.582 | <0.0001 | - | - | - |
R0 resection | 3.647 | 2.144, 6.203 | <0.0001 | 3.681 | 1.640, 8.263 | 0.002 |
pN0 status | 5.084 | 3.723, 6.942 | <0.0001 | 3.209 | 1.835, 5.611 | <0.0001 |
MSI | 0.610 | 0.350, 1.062 | 0.081 | - | - | - |
(b) | ||||||
Univariable | Multivariable | |||||
Variable | HR | 95% CI | p | HR | 95% CI | p |
Age (years) | 0.986 | 0.967, 1.006 | 0.173 | - | - | - |
Male | 0.918 | 0.705, 1.195 | 0.525 | - | - | - |
cTNM stage I–II | 2.263 | 1.263, 1.643 | <0.0001 | - | - | - |
cTNM stage III | 0.399 | 0.287, 0.555 | <0.0001 | - | - | - |
R0 resection | 1.001 | 1.007, 1.013 | 0.048 | 1.016 | 1.001, 1.030 | 0.036 |
pN0 status | 2.749 | 2.092, 3.614 | <0.0001 | 3.187 | 1.660–6.121 | <0.0001 |
MSI | 0.375 | 0.143, 0.984 | 0.046 | - | - | - |
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Zaborowski, A.M., on behalf of REACCT Collaborative. Colorectal Cancer in the Young: Research in Early Age Colorectal Cancer Trends (REACCT) Collaborative. Cancers 2023, 15, 2979. https://doi.org/10.3390/cancers15112979
Zaborowski AM on behalf of REACCT Collaborative. Colorectal Cancer in the Young: Research in Early Age Colorectal Cancer Trends (REACCT) Collaborative. Cancers. 2023; 15(11):2979. https://doi.org/10.3390/cancers15112979
Chicago/Turabian StyleZaborowski, Alexandra M. on behalf of REACCT Collaborative. 2023. "Colorectal Cancer in the Young: Research in Early Age Colorectal Cancer Trends (REACCT) Collaborative" Cancers 15, no. 11: 2979. https://doi.org/10.3390/cancers15112979