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Published on: September 27, 2024
Left-sided early onset colorectal carcinomas: A sporadic neoplasm with aggressive behavior
Emanuela Pilozzi1, Laura Lorenzon2, Simone Lo Baido1
1Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy.
Background:
Early onset (≤50y) colorectal carcinomas (EO-CRCs) are increasing in incidence according to epidemiological data. We investigated clinical-pathological, molecular features and outcomes of 62 left sided EO-CRCs (EOLS-CRCs) and compared them to a group of late onset (≥65) LS-CRCs (LOLS-CRCs).
Materials And Methods:
Samples were evaluated for pathological features and microsatellite instability (MSI). Overall survival (OS), disease free survival (DFS) and disease specific survival were evaluated in both groups.
Results:
Five out 62 (8%) EOLS-CRCs showed MSI phenotype. Interestingly these cases were aged 26-39y. Most EOLS-CRCs present at advanced stage and this was statistically significant when compared to LOLS-CRCs. OS was better in EOLS-CRCs whilst DFS showed a worst profile in EOLS-CRCs either in low and high stages even though young patients were treated more often with adjuvant chemotherapy compared to older ones at the same disease stage.
Conclusions:
Most EOLS-CRCs are sporadic non Lynch, microsatellite stable (MSS) CRCs. Our data show that when compared with LOLS-CRCs the early group represents an aggressive disease with worst outcome underlining a possible different carcinogenic pathway.
