Gastrointestinal tract carcinoma in pediatric and adolescent age: The Italian TREP project experience
Alice Indini1, Gianni Bisogno2, Giovanni Cecchetto3
1Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Insights
Pediatric gastrointestinal (GI) carcinomas are rare and aggressive. This study of 15 children and adolescents found most had advanced colorectal cancer, requiring chemotherapy and surgery, with ongoing research needed for targeted therapies.
Area of Science:
- Oncology
- Pediatric Oncology
- Gastrointestinal Oncology
Background:
- Gastrointestinal (GI) carcinomas are exceptionally rare in pediatric and adolescent populations.
- This study focuses on children and adolescents diagnosed with GI carcinoma.
Purpose of the Study:
- To report the clinical features, treatment, and outcomes of pediatric and adolescent GI carcinoma patients.
- To analyze data prospectively collected within the Italian Tumori Rari in Età Pediatrica (TREP) project.
Main Methods:
- Prospective registration of pediatric and adolescent GI carcinoma cases within the TREP project (2000-2016).
- Development of diagnostic and therapeutic guidelines based on adult recommendations.
- Centralized registration and review of clinical data.
Main Results:
- Fifteen patients were registered, with colorectal carcinomas being the most common (12 cases).
- Most patients presented with advanced-stage (III-IV) disease and aggressive histological subtypes.
- Surgery was performed in 13 patients, chemotherapy in all, with limited use of radiotherapy and bevacizumab. Six patients died from disease progression.
Conclusions:
- Pediatric GI tract carcinomas are confirmed as rare and biologically aggressive.
- Further prospective studies are essential to investigate the unique biology of these tumors in young patients.
- Identifying novel therapeutic targets is crucial for improving outcomes in this age group.
Background:
Gastrointestinal (GI) carcinomas are very rare in the pediatric and adolescent age range. We report the clinical features, treatment, and outcome of a series of children and adolescents with GI carcinoma prospectively registered in the Italian Tumori Rari in Età Pediatrica (TREP) project.
Methods:
The TREP project developed diagnostic and therapeutic guidelines based on recommendations currently in use for adults. Clinical data were centrally registered and reviewed.
Results:
Fifteen patients were registered over the years 2000-2016. Most of the tumors were colorectal carcinomas (12 cases). All but one patient had advanced-stage disease (American Joint Committee on Cancer stages III-IV), and the majority of patients had aggressive histological subtypes, i.e. poorly differentiated (G3) (five patients), mucinous (four patients), and signet ring (two patients) adenocarcinomas. Surgery was performed in 13 of 15 patients, and was radical in nine of 13 patients. Only one patient received postoperative radiotherapy. All patients received chemotherapy, with the addition of bevacizumab in two cases. Nine patients were still alive at the time of the present report, but two of them had only just completed their treatment program and one patient is still on treatment. Six patients died due to disease progression.
Conclusions:
This prospective report on pediatric GI tract carcinomas confirms the rarity and biological aggressiveness of these diseases in pediatric and adolescent age. Further prospective studies are needed to explore the distinct biology of tumor in this age group in order to find new therapeutic targeted agents.
