The challenge posed by young-onset rectal cancer

Denost, Quentin

doi:10.1002/bjs.11591

Cited by 11 publications

(5 citation statements)

References 14 publications

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“…The exclusion criteria: (1) patients with more than one malignancy; (2) patients with survival time less than 1 month; (3)…”

Section: Database and Variablesmentioning

confidence: 99%

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Development and validation of a nomogram to predict overall survival in young non-metastatic rectal cancer patients after curative resection: a population-based analysis

Jia

et al. 2022

Int J Colorectal Dis

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Purpose This study aimed to establish and validate a nomogram for predicting overall survival (OS) in young non-metastatic rectal cancer (RC) patients after curative resection. Methods Young RC patients (under 50 years of age) from 2010 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Those patients randomly assigned to a training cohort and a validation cohort at a ratio of 7:3. The independent prognostic factors for OS were identified by univariate and multivariate Cox regression analysis. A nomogram model was built based on the independent prognostic variables and was evaluated by concordance index (C-index), receiver operating characteristics (ROC) curves, calibration plot, and decision curve analysis (DCA). Results A total number of 3026 young RC patients were extracted from SEER database. OS nomogram was constructed based on race, histological type, tumor grade, T stage, N stage, carcinoembryonic antigen (CEA) level, and number of lymph nodes (LN) examined. C-index, ROC curves, calibration plot, and DCA curves presented satisfactory performance of the above nomogram in predicting the prognosis of young non-metastatic RC patients after curative resection. The nomogram can identify three subgroups of patients at different risks, which showed different prognostic outcomes both in the training cohort and validation cohort. Conclusion We successfully established a reliable and insightful nomogram to predict OS for young non-metastatic RC patients after curative resection. The nomogram may provide accurate prognosis prediction to guide individualized follow-up and treatment plans.

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“…The exclusion criteria: (1) patients with more than one malignancy; (2) patients with survival time less than 1 month; (3)…”

Section: Database and Variablesmentioning

confidence: 99%

“…RC is traditionally known as a malignancy in the elderly. The incidence of patients with RC has shown a downward trend over the past few decades [2,3]. Unfortunately, recent studies have reported an increasing incidence of young RC patients under 50 years of age [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a nomogram to predict overall survival in young non-metastatic rectal cancer patients after curative resection: a population-based analysis

Jia

et al. 2022

Int J Colorectal Dis

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“…Lynch syndrome, familial adenomatous polyposis); however, the majority are sporadic [6]. A combination of lifestyle factors (obesity, inactivity, low‐fibre diet, smoking and alcohol), genetic predisposition and alterations to gut microbiota are all suggested as potential aetiological factors [7]. More than 95% of cases of CRC in the Western world are believed to develop from adenomatous polyps via the adenoma–carcinoma sequence.…”

Section: Introductionmentioning

confidence: 99%

The protective role of phosphodiesterase inhibitors in preventing colorectal cancer and advanced colorectal polyps: a systematic review and meta‐analysis

Cullinane,

Brett,

Devane

et al. 2023

Colorectal Disease

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AimInflammatory cells within the tumour microenvironment are the driving forces behind colorectal cancer (CRC) tumourigenesis. Understanding the different pathways involved in CRC carcinogenesis paves the way for effective repurposing of drugs for cancer prevention. Emerging data from preclinical and clinical studies suggest that, due to their antiproliferative and anti‐inflammatory properties, phosphodiesterase‐5 inhibitors (PDE5i) might have an anticancer effect. The aim of this study was to clarify through systematic review and meta‐analysis of published peer‐reviewed studies whether an association exists between PDE5i use and CRC risk.MethodThis study was guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines. Prospective registration was performed on PROSPERO (CRD42022372925). A systematic review was performed for studies reporting CRC and advanced colorectal polyp incidence in PDE5i ‘ever‐users’ and PDE5i ‘never‐users’. Meta‐analysis was performed using RevMan version 5.ResultsFour observational cohort studies and two case–control studies, comprising 995 242 patients were included in the final analysis, of whom 347 126 were PDE5i ever‐users. Patients who were PDE5i ever‐users had a significantly lower incidence of CRC or advanced colorectal polyps than never‐users (OR 0.88, CI 0.79–0.98, p = 0.02). To examine the primary preventative role of PDE5i, subgroup analysis of four studies including patients without a previous history of CRC found that use of PDE5i was associated with a lower incidence of CRC (OR 0.85, CI 0.75–0.95, p = 0.005, I2 = 64%). There was no significant temporal relationship found between PDE5i use and CRC risk as both current users and previous users had a significantly lower incidence of CRC than never‐users.ConclusionOur study found a significant anticancer effect of PDE5i, as shown by a reduced risk of CRC in the context of both primary and secondary CRC prevention.

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“…The importance of measuring functional outcomes after treatment for rectal cancer in addition to post-operative morbidity and oncological outcomes is increasingly recognized and reported. There is a paucity of data examining functional impairment after rectal cancer treatment in young-onset patients ( 30 ). This study evaluated gastrointestinal, genitourinary and fertility concerns in a large cohort of young-onset rectal cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

2022

Front. Oncol.

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BackgroundImpairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (<50 years) is rising, there is little data on functional outcomes in this group.MethodsThe REACCT international collaborative database was reviewed and data on eligible patients analysed. Inclusion criteria comprised patients with a histologically confirmed rectal cancer, <50 years of age at time of diagnosis and with documented follow-up including functional outcomes.ResultsA total of 1428 (n=1428) patients met the eligibility criteria and were included in the final analysis. Metastatic disease was present at diagnosis in 13%. Of these, 40% received neoadjuvant therapy and 50% adjuvant chemotherapy. The incidence of post-operative major morbidity was 10%. A defunctioning stoma was placed for 621 patients (43%); 534 of these proceeded to elective restoration of bowel continuity. The median follow-up time was 42 months. Of this cohort, a total of 415 (29%) reported persistent impairment of functional outcomes, the most frequent of which was bowel dysfunction (16%), followed by bladder dysfunction (7%), sexual dysfunction (4.5%) and infertility (1%).ConclusionA substantial proportion of patients with early-onset rectal cancer who undergo surgery report persistent impairment of functional status. Patients should be involved in the discussion regarding their treatment options and potential impact on quality of life. Functional outcomes should be routinely recorded as part of follow up alongside oncological parameters.

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The challenge posed by young-onset rectal cancer

Cited by 11 publications

References 14 publications

Development and validation of a nomogram to predict overall survival in young non-metastatic rectal cancer patients after curative resection: a population-based analysis

Development and validation of a nomogram to predict overall survival in young non-metastatic rectal cancer patients after curative resection: a population-based analysis

The protective role of phosphodiesterase inhibitors in preventing colorectal cancer and advanced colorectal polyps: a systematic review and meta‐analysis

Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

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