Treatment patterns in metastatic early-onset rectal cancer

Area of Science:

• Oncology
• Gastroenterology
• Public Health

Background:

• Early onset rectal cancer (EORC) is a growing global concern.
• Distinct clinical features of EORC suggest potential differences in management, though evidence is limited.
• This study investigates treatment patterns and outcomes for EORC versus late-onset rectal cancer (LORC) in New Zealand.

Purpose of the Study:

• To compare treatment strategies for EORC and LORC.
• To evaluate the impact of age of onset on patient outcomes in metastatic rectal cancer.
• To inform appropriate treatment strategies for varying age groups with rectal cancer.

Main Methods:

• Retrospective analysis of stage 4 rectal adenocarcinoma patients in Canterbury, New Zealand (2010-2021).
• Comparison of patients under 50 (EORC) with a control group aged 60-74 (LORC).
• Analysis of treatment patterns, hospital stays, and survival outcomes.

Main Results:

• EORC patients (n=23) demonstrated significantly longer median survival (47.9 months) compared to LORC patients (n=64, 26.5 months; P=0.03).
• No significant differences were observed in surgical or oncological management between the age groups (P>0.05).
• Hospitalization burden was comparable between EORC and LORC groups, with no significant difference in the proportion of time spent in hospital.

Conclusions:

• Surgical and oncological treatments were consistent across EORC and LORC groups.
• EORC patients experienced superior survival outcomes compared to LORC patients.
• Findings emphasize a balanced approach to metastatic rectal cancer management, prioritizing both survival and quality of life.