TY - JOUR
T1 - Distinct features of colorectal cancer in children and adolescents
T2 - A population-based study of 159 cases
AU - Sultan, Iyad
AU - Rodriguez-Galindo, Carlos
AU - El-Taani, Hani
AU - Pastore, Guido
AU - Casanova, Michela
AU - Gallino, Gianfranco
AU - Ferrari, Andrea
PY - 2010/2/1
Y1 - 2010/2/1
N2 - BACKGROUND: Colorectal cancer is exceedingly rare in children and adolescents. Reports from small series indicate that poor prognostic factors are more common in children than in adults, resulting in worse outcome for the pediatric population. METHODS: The Surveillance, Epidemiology, and End Results database was searched for records of children/ adolescents with colorectal cancer, and the features and outcomes were compared with those of adults. RESULTS: From January 1973 through December 2005, only 159 children/adolescents (ages 4-20 years) were reported with a diagnosis of colorectal cancer. The most common sites of involvement were the rectum (27%) and the transverse colon (26%). Adenocarcinoma was the most common histiotype in both adults and pediatric patients; however, children/adolescents had more unfavorable histiotypes (ie, mucinous adenocarcinoma [22%] and signet ring cell carcinoma [18%]) when compared with adults (10% and 1%, respectively; P <.001). Poorly differentiated and undifferentiated tumors (grades III and IV, respectively) and distant stage were more common in children/adolescents (P <.001). The 5-year relative survival estimates in children/adolescents and adults were 40% ± 4.2% and 60% ± 0.10%, respectively, confirming a worse outcome in the pediatric age group (P <.001). CONCLUSIONS: Children/adolescents represent a minority of patients with colorectal cancer and have high-risk features and worse outcome than adults. The small number of patients in this age group was an impediment to the development of meaningful clinical trials. Thus, the principles of management for adult colorectal cancer should be used in the treatment of children and adolescents.
AB - BACKGROUND: Colorectal cancer is exceedingly rare in children and adolescents. Reports from small series indicate that poor prognostic factors are more common in children than in adults, resulting in worse outcome for the pediatric population. METHODS: The Surveillance, Epidemiology, and End Results database was searched for records of children/ adolescents with colorectal cancer, and the features and outcomes were compared with those of adults. RESULTS: From January 1973 through December 2005, only 159 children/adolescents (ages 4-20 years) were reported with a diagnosis of colorectal cancer. The most common sites of involvement were the rectum (27%) and the transverse colon (26%). Adenocarcinoma was the most common histiotype in both adults and pediatric patients; however, children/adolescents had more unfavorable histiotypes (ie, mucinous adenocarcinoma [22%] and signet ring cell carcinoma [18%]) when compared with adults (10% and 1%, respectively; P <.001). Poorly differentiated and undifferentiated tumors (grades III and IV, respectively) and distant stage were more common in children/adolescents (P <.001). The 5-year relative survival estimates in children/adolescents and adults were 40% ± 4.2% and 60% ± 0.10%, respectively, confirming a worse outcome in the pediatric age group (P <.001). CONCLUSIONS: Children/adolescents represent a minority of patients with colorectal cancer and have high-risk features and worse outcome than adults. The small number of patients in this age group was an impediment to the development of meaningful clinical trials. Thus, the principles of management for adult colorectal cancer should be used in the treatment of children and adolescents.
KW - Adenocarcinoma
KW - Adolescents
KW - Children
KW - Colon
KW - Colorectal cancer
KW - End results (SEER)
KW - Epidemiology
KW - Surveillance
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U2 - 10.1002/cncr.24777
DO - 10.1002/cncr.24777
M3 - Article
C2 - 19957323
AN - SCOPUS:76249128517
VL - 116
SP - 758
EP - 765
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 3
ER -