Clinico-pathological patterns and survival outcome of colorectal cancer in young patients: western Saudi Arabia experience.

Mervat Mahrous Mohamed,Hani Abdalla El Taani,Shereef Ahmed Elsamany,Soha Ali Elmorsy,Rasha Mostafa Haggag,Ahmed Abdel-Reheem Alnagar,Abdullah Saeed Alzahrani,Ahmed Saleh Al-Shehri,Jamal Eddin Zekri

doi:10.7314/apjcp.2014.15.13.5239

Mervat Mahrous Mohamed, Hani Abdalla El Taani + Show 7 more

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https://doi.org/10.7314/apjcp.2014.15.13.5239

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Abstract

The prognosis of young colorectal cancer (CRC) patients has been addressed by several studies but with contradictory results. The aim of the present study was to evaluate the clinico-pathological features of young Saudi patients with CRC in addition to displaying their survival outcome. In this retrospective study, young CRC patients (≤ 40 years) diagnosed between 2007 and 2011 from 4 centres in western Saudi Arabia, were included. Clinico-pathological features, tumor markers, dates of disease relapse and death were collected. Survival parameters were compared with those of older Saudi patients, reported in previous studies. One hundred and sixteen young patients with CRC were identified (32.2% rectal, 67.8% colon). Some 44% were metastatic while 32.7% had stage III at diagnosis. Patients with grade 3 tumors made up 29.4% of the total while 49.5% had positive lymphovascular invasion (LVI), 56% had a lymph node (LN) ratio ≥ 0.2 and 40.2% were K-ras mutant. Median disease-free survival (DFS) and overall survival (OS) in non-metastatic cases were 22.8 and 49.6 months respectively with better median DFS in K-ras wild compared to mutant patients (28.5 vs 20.9 months, p=0.005). In metastatic cases, median OS was 19.5 months. These survival outcomes are inferior compared to those of older Saudi patients reported in prior studies. Young CRC patients present more commonly with advanced stage and a high incidence of adverse prognostic factors such as LVI and high LN ratio. Young CRC patients seem to have worse survival compared to older Saudi patients.

Highlights

In Saudi Arabia, colorectal cancer (CRC) incidence, morbidity and related mortality have been steadily increasing over the past twenty years (Ibrahim et al, 2008)
In this retrospective study involving patients from 4 centres in western Saudi Arabia, young colorectal cancer patients were identified through review of medical records
We evaluated the clinicopathological features and survival patterns of young CRC

Summary

Introduction

In Saudi Arabia, CRC incidence, morbidity and related mortality have been steadily increasing over the past twenty years (Ibrahim et al, 2008). There were 904 new cases of CRC accounting for 10.2 % of all newly diagnosed cancer patients in 2008 (Bazarbashi et al, 2008) This cancer ranks first among males and third among female population (male to female ratio of 112:100) with median age at diagnosis of 59 years in males and 57 years in females (Bazarbashi et al, 2008). In Saudi population, 20.9 % of CRC patients are younger than 45 years of age (Mosli, 2012a). The aim of the present study was to evaluate the clinico-pathological features of young Saudi patients with CRC in addition to displaying their survival outcome. These survival outcomes are inferior compared to those of older Saudi patients reported in prior studies. Young CRC patients seem to have worse survival compared to older Saudi patients

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