Clinicopathologic Profile and Treatment Outcomes of Colorectal Cancer in Young Adults: A Multicenter Study From India
Year: 2024
Type: article
Study design: Observational Study
Abstract: PURPOSE: Colorectal cancer (CRC) in young adults is a rising concern in developing countries such as India. This study investigates clinicopathologic profiles, treatment patterns, and outcomes of CRC in young adults, focusing on adolescent and young adult (AYA) CRC in a low- and middle-income country (LMIC). METHODS: A retrospective registry study from January 2018 to December 2020 involved 126 young adults (age 40 years and younger) with CRC. Patient demographics, clinical features, tumor characteristics, treatment modalities, and survival outcomes were analyzed after obtaining institutional ethics committees' approval. RESULTS: Among 126 AYA patients, 62.70% had colon cancer and 37.30% had rectal cancer. Most patients (67%) were age 30-39 years, with no significant gender predisposition. Females had higher metastatic burden. Abdominal pain with obstruction features was common. Adenocarcinoma (65%) with signet ring differentiation (26%) suggested aggressive behavior. Limited access to molecular testing hindered mutation identification. Capecitabine-based chemotherapy was favored because of logistical constraints. Adjuvant therapy showed comparable recurrence-free survival in young adults and older patients. For localized colon cancer, the 2-year median progression-free survival was 74%, and for localized rectal cancer, it was 18 months. Palliative therapy resulted in a median overall survival of 33 months (95% CI, 18 to 47). Limited access to targeted agents affected treatment options, with only 27.5% of patients with metastatic disease receiving them. Chemotherapy was generally well tolerated, with hematologic side effect being most common. CONCLUSION: This collaborative study in an LMIC offers crucial insights into CRC in AYA patients in India. Differences in disease characteristics, treatment patterns, and limited access to targeted agents highlight the need for further research and resource allocation to improve outcomes in this population.
Source: JCO Global Oncology
DOI: 10.1200/go.23.00225
Authors: Amit Sehrawat, Mridul Khanna, Smita Kayal, Deepak Sundriyal, Shraddha Tiwari, Sunu Cyriac, Praveen Ravishankaran, Jomon Raphael, Dominic Mathew, Soumya Surath Panda, Laltendu Moharana, Sumit Subhadarshi Mohanty, Swati Sucharita Mohanty, Ashwin Philips, Deepak Jain, Pamela Jeyaraj, Parvez Haque David, Jaineet Patil, S.V. Saju, Krishnakumar Rathnam, Neha Sharma, Kaaviya Dheva, Sree Rekha Jinkala, Kalyarasaran Raja, Prasanth Penumadu, Prasanth Ganesan
Institutions: All India Institute of Medical Sciences Rishikesh, Jawaharlal Institute of Post Graduate Medical Education and Research, Siksha O Anusandhan University, Institute of Medical Sciences and Sum Hospital, Amala Institute of Medical Sciences, Christian Medical College, Meenakshi Mission Hospital and Research Centre, Indian Council of Medical Research, National Centre for Disease Informatics and Research
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,472
OpenAlex ID: W4396980348