Gastrointestinal tract carcinoma in pediatric and adolescent age: The Italian TREP project experience

Indini, Alice; Bisogno, Gianni; Cecchetto, Giovanni; Vitellaro, Marco; Signoroni, Stefano; Massimino, Maura; Riccipetitoni, Giovanna; Zecca, Marco; Dall’Igna, Patrizia; Pasquale, Maria Debora De; Inserra, Alessandro; Chiaravalli, Stefano; Basso, Eleonora; Virgone, Calogero; Sorbara, Silvia; Bartolomeo, Maria Di; D’Angelo, Paolo; Ferrari, Andrea

doi:10.1002/pbc.26658

Cited by 24 publications

(29 citation statements)

References 64 publications

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“…By contrast, publications comparing patients younger than 50 years of age with those > 50 years showed a better prognosis among the younger patients (Kneuertz et al ., ; Kolarich et al ., ; Vatandoust et al ., ; Wang et al ., ). This suggests that in patients with very early‐onset CRC (< 35 years old) a different biological background likely underlies an earlier and faster CRC progression (Ferrari et al ., ; Indini et al ., ; Khan et al ., ; Zhao et al ., ).…”

Section: Methodsmentioning

confidence: 98%

“…In 61% of patients < 50 years (Kneuertz et al ., ) and up to 76% of patients < 30 years (Indini et al ., ; Kam et al ., ; Khan et al ., ), CRC is diagnosed as stage III or IV, strikingly different from older CRC patients (46–50% diagnosed as stage III or IV; Ferrari et al ., ; Khan et al ., ; Kneuertz et al ., ). EO‐CRCs are more frequently poorly differentiated G3 tumors, left‐sided and rectal (Chang et al ., ; Indini et al ., ; Kam et al ., ; Khan et al ., ; Kneuertz et al ., ; Sultan et al ., ; Wang et al ., ). Signet ring cell CRC, accounting for < 1% of all CRC, among younger patients account for 3–13% of cases, especially in those younger than 30 years (Chang et al ., ; Khan et al ., ; Kneuertz et al ., ; Wang et al ., ; Yantiss et al ., ).…”

Section: Methodsmentioning

confidence: 99%

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Early‐onset colorectal cancer in young individuals

et al. 2018

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Treatment of young adults with colorectal cancer (CRC) represents an unmet clinical need, especially as diagnosis in this population might lead to the greatest loss of years of life. Since 1994, CRC incidence in individuals younger than 50 years has been increasing by 2% per year. The surge in CRC incidence in young adults is particularly alarming as the overall CRC frequency has been decreasing. Early‐onset CRC are characterized by a more advanced stage at diagnosis, poorer cell differentiation, higher prevalence of signet ring cell histology, and left colon‐sided location of the primary tumor. Among EO‐CRC, approximately 30% of patients are affected by tumors harboring mutations causing hereditary cancer predisposing syndromes, and 20% have familial CRC. Most notably, the remaining 50% of EO‐CRC patients have neither hereditary syndromes nor familial CRC, thus representing a formidable challenge for research. In this review article we summarize epidemiology, clinical and molecular features, heredity and outcome of treatments of EO‐CRC, and provide considerations for future perspectives.

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Section: Methodsmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

Early‐onset colorectal cancer in young individuals

et al. 2018

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“…The establishment of larger International cooperative networks 43,44 is necessary to better define epidemiology, prognostic factors, the impact of local and systemic therapies, and the overall survival. The nationwide multidisciplinary TREP experience demonstrated over the years that cooperative studies on such very rare tumors are feasible 20,31,45 . The keys for success are the capability to meet both the need of data collection and research, as well as to provide a network of experts able to offer practical patient management approaches along with an advisory service.…”

Section: Discussionmentioning

confidence: 99%

Extra‐appendicular neuroendocrine tumors: A report from the TREP project (2000‐2020)

Virgone

Ferrari

Chiaravalli

et al. 2021

Pediatric Blood & Cancer

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Background Extra‐appendicular neuroendocrine tumors (NETs) are very rare tumors. While diagnostic and therapeutic guidelines are well established for adults, data on children and adolescents are lacking. Patients and Methods Patients with a diagnosis of extra‐appendicular NET registered on the Tumori Rari in Età Pediatrica ‐ Rare Tumors in Pediatric Age (TREP) from 2000 to 2020 were analyzed. Clinical characteristics including patients’ presentation, tumor features, treatment, and outcome were reviewed. Results Twenty‐seven patients with extra‐appendicular NET registered on TREP with a median age of 173 months. The primary site was the pancreas (12) or bronchi (10) in the majority of cases. Other primary sites included the thymus, Meckel's diverticulum, and liver. Thirteen (48%) of tumors extended beyond the organ of origin: four invaded neighboring organs and/or regional nodes and nine involved distant metastases. The 3‐year event‐free survival (EFS) for those with localized disease was superior to those with metastatic disease (66.6% 95% CI 5‐95% vs 33% 95% CI 5‐68%, respectively; P = .005). A complete resection was feasible in 17 patients. The 3‐year EFS in these patients was superior to those with no or incomplete resection (R0 vs R1/R2, respectively; P = .007). Overall, 16 children had no evidence of disease at follow‐up, and one is alive with disease; five died, and five were lost to follow‐up. Conclusions Data from our experience demonstrated a wide heterogeneity of presentation and outcome of these tumors. Localized disease and complete surgical resection were the main prognostic factors of good outcome. Other therapies may have a role in prolonging survival in metastatic disease.

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“…However, most cases of EO-CRC are sporadic and are likely linked to environmental, behavioral, and dietary factors [8]. EO-CRC is characterized by a more advanced stage at diagnosis, with a striking 76% of patients < 30 years diagnosed at a locally advanced or metastatic stage in contrast with 46-50% of older CRC patients [53][54][55]. Moreover, while in the last decade survival outcome has improved in late-onset CRC (LO-CRC), EO-CRC survival has not, its prognosis becoming even worse with decreasing patients age [56].…”

Section: Increased Crc Incidence In the Young Adult Population: Molecmentioning

confidence: 99%

Dietary Factors in the Control of Gut Homeostasis, Intestinal Stem Cells, and Colorectal Cancer

2019

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Colorectal cancer (CRC) is the third commonly diagnosed cancer and the second leading cause of cancer-related deaths worldwide. Global CRC burden is expected to increase by 60% in the next decade, with low-income countries experiencing an escalation of CRC incidence and mortality in parallel to the adoption of western lifestyles. CRC incidence is also sharply increasing in individuals younger than 50 years, often presenting at advanced stages and with aggressive features. Both genetic and environmental factors have been recognized as major contributors for the development of CRC, the latter including diet-related conditions such as chronic inflammation and obesity. In particular, a diet rich in fat and sugars (Western-style diet, WSD) has been shown to induce multiple pathophysiological changes in the intestine linked to an increased risk of CRC. In this scenario, dietary factors have been recently shown to play novel unexpected roles in the regulation of intestinal stem cells (ISCs) and of the gut microbiota, which represent the two main biological systems responsible for intestinal homeostasis. Furthermore, diet is increasingly recognized to play a key role in the neoplastic transformation of ISCs and in the metabolic regulation of colorectal cancer stem cells. This review illustrates novel discoveries on the role of dietary components in regulating intestinal homeostasis and colorectal tumorigenesis. Particular focus is dedicated to new areas of research with potential clinical relevance including the effect of food components on ISCs and cancer stem cells (CSCs), the existence of CRC-specific microbial signatures and the alterations of intestinal homeostasis potentially involved in early-onset CRC. New insights on the role of dietary factors in intestinal regulation will provide new tools not only for the prevention and early diagnosis of CRC but also for improving the effectiveness of current CRC therapies.

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Gastrointestinal tract carcinoma in pediatric and adolescent age: The Italian TREP project experience

Cited by 24 publications

References 64 publications

Early‐onset colorectal cancer in young individuals

Early‐onset colorectal cancer in young individuals

Extra‐appendicular neuroendocrine tumors: A report from the TREP project (2000‐2020)

Dietary Factors in the Control of Gut Homeostasis, Intestinal Stem Cells, and Colorectal Cancer

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