CLINICAL PRESENTATION, PATHOLOGICAL STAGING, AND DISEASE-FREE SURVIVAL OF COLORECTAL CANCER IN YOUNG ADULTS

Introduction Colorectal cancer is the second most frequent malignant tumor in men and women in Brazil and ranks as the second leading cause of mortality from malignant neoplasms worldwide. Additionally, its incidence has been increasing among young adults.

Objective To study the clinical presentation, pathological staging, and disease-free survival of colorectal cancer in young adults.

Method This case series study analyzed 41 oncology patients up to 45 years of age who were diagnosed and treated between 2010 and 2022. The variables collected included sex, age, body mass index (BMI), comorbidities (hypertension, diabetes mellitus, and smoking), American Society of Anesthesiologists (ASA) classification, tumor location, staging, postoperative complications, follow-up, and disease-free survival outcomes.

Results The study included 41 patients with a median age of 40 years (range: 23–45), of whom 24 were women (58.5%) with an average BMI of 23.13 kg/m². One patient had systemic arterial hypertension, two had diabetes mellitus, and one was a smoker. According to the ASA classification, 17 patients were classified as ASA 1, 17 as ASA 2, and 7 as ASA 3. The cases included 4 right colon adenocarcinomas, 17 left colon adenocarcinomas, and 20 rectal adenocarcinomas. Regarding staging, 11 patients were stage I, 5 were stage II, 20 were stage III, and 5 were stage IV. Surgical approaches included 21 open surgeries and 20 laparoscopic surgeries. Postoperative complications occurred in 15 patients (36.5%), including urinary retention (6 patients), paralytic ileus (3 patients), pelvic abscess (3 patients), wound dehiscence (1 patient), pancreatic fistula (1 patient), and fever (1 patient), with no reported deaths. The average follow-up period was 35.59 months, and the disease-free survival rate for stage I to III patients was 87.8%.

Conclusion This case series analyzed 41 young oncology patients. Despite a 36.5% rate of postoperative complications, surgical intervention proved to be the gold standard treatment, with no operative mortality reported. Furthermore, the disease-free survival rate for patients in stages I, II, and III was 87.8%. These findings underscore the importance of appropriate management for favorable prognoses in colorectal cancer patients.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025