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NCCN Guideline Concordance Improves Survival in Pediatric and Young Adult Rectal Cancer

Colleen P Nofi1, Sara Siskind2, Gary B Deutsch3

  • 1Cohen Children's Medical Center, Division of Pediatric General, Thoracic, and Endoscopic Surgery, 269-01 76th Avenue, Queens NY 11040, USA; Northwell North Shore/Long Island Jewish, Department of Surgery, 300 Community Drive, Manhasset NY 11030, USA.

Journal of Pediatric Surgery
|October 30, 2023
PubMed

Insights

Management guidelines for pediatric and young adult rectal cancer are lacking. Adhering to National Comprehensive Cancer Network (NCCN) guidelines for rectal cancer improves survival in these young patients.

Area of Science:

  • Oncology
  • Clinical Research
  • Cancer Management

Background:

  • No established management guidelines exist for pediatric and young adult rectal cancer.
  • Adult rectal cancer management guidelines are well-documented, but a gap exists for younger populations.

Purpose of the Study:

  • To evaluate the adherence to National Comprehensive Cancer Network (NCCN) guidelines in pediatric and young adult rectal cancer patients.
  • To assess the impact of guideline-concordant therapy on survival outcomes in these patient groups.

Main Methods:

  • Retrospective analysis of the National Cancer Database (2004-2018).
  • Inclusion of pediatric (0-21 years) and young adult (22-40 years) patients diagnosed with rectal cancer.
  • Evaluation of pre-operative and post-operative guideline concordance and its correlation with survival using Cox regression and Kaplan-Meier analysis.

Main Results:

  • 89.6% of pediatric and 84.6% of young adult patients received pre-operative guideline-concordant therapy.
  • Pediatric patients were less likely to receive post-operative guideline-concordant therapy compared to young adults (65.3% vs. 76.7%).
  • Guideline-concordant therapy significantly reduced the risk of death in both pediatric and young adult rectal cancer patients.

Conclusions:

  • National Comprehensive Cancer Network (NCCN)-based guidelines can effectively guide peri-operative management and enhance survival in pediatric and young adult rectal cancer.
  • Due to the rarity of rectal cancer in young patients, a multidisciplinary team approach and patient/family involvement are crucial for optimal treatment strategies.
Abstract

Keywords:
GuidelinesNCCNPediatricRectal cancer

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