Colorectal carcinoma in pediatric patients: A comparison with adult tumors, treatment and outcomes from the National Cancer Database.
Journal of pediatric surgery
Adenocarcinoma, Mucinous, Adolescent, Adult, Age Distribution, Age Factors, Aged, Aged, 80 and over, Carcinoma, Signet Ring Cell, Chi-Square Distribution, Child, Cohort Studies, Colonic Neoplasms, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Staging, Proportional Hazards Models, Rectal Neoplasms, Survival Analysis, Treatment Outcome, Young Adult
BACKGROUND: Pediatric colorectal cancer (CRC) is rare. Comparison with adult CRC tumors, management, and outcomes may identify opportunities for improvement in pediatric CRC care.
STUDY DESIGN: CRC patients in the National Cancer Data Base from 1998 to 2011, were grouped into Pediatric (≤21years), early onset adult (22-50) and older adult (>50) patients. Groups were compared with χ(2) and survival analysis.
RESULTS: A total of 918 pediatric (Ped), 157,779 early onset adult (EA), and 1,304,085 older adults (OA) were identified (p
CONCLUSIONS: This is the largest cohort of pediatric CRC patients, revealing more aggressive tumor histology and behavior in children, particularly in rectal cancer. Despite standard oncologic treatment, age ≤21 was a significant predictor of mortality. This is likely owing to worse tumor biology rather than treatment disparities and may signal the need for different therapeutic strategies.
Poles, Gabriela C; Clark, David E; Mayo, Sara W; Beierle, Elizabeth A; Goldfarb, Melanie; Gow, Kenneth W; Goldin, Adam; Doski, John J; Nuchtern, Jed G; Vasudevan, Sanjeev A; and Langer, Monica, "Colorectal carcinoma in pediatric patients: A comparison with adult tumors, treatment and outcomes from the National Cancer Database." (2016). Maine Medical Center. 363.