caa a22 4500 445333626 CHVBK 20180317142745.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1245/s10434-011-1674-7 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1674-7 Young-Onset Rectal Cancer: Presentation, Pattern of Care and Long-term Oncologic Outcomes Compared to a Matched Older-Onset Cohort [Elektronische Daten] [Y. You, Eric Dozois, Lisa Boardman, Jeremiah Aakre, Marianne Huebner, David Larson] Background: Recent population-based studies have highlighted a disproportionate increase in the incidence of rectal cancer among adults younger than aged 50years. To determine whether different intervention and surveillance strategies might be needed for younger patients, the patterns of care and oncologic outcomes among adults younger than aged 50years with rectal cancer were investigated. Methods: A cohort of 333 young (<50years) patients with sporadic rectal cancer was compared to a contemporaneous cohort of 675 older (>65years) patients for differences in disease pattern, treatments received, and long-term disease-free survival (DFS). Results: Patient and tumor characteristics did not differ between groups except for an increased presence of signet-ring and mucinous histology in young patients. Younger patients presented with more advanced-stage disease (stages III and IV: 59.4% vs. 46.4%; p=0.016). More young patients received sphincter-preservation procedures (63.4 vs. 55.4%; p=0.016), radiation (61.6 vs. 42.1%; p<0.001), and chemotherapy (67.3 vs. 47.6%; p<0.001). Fewer young patients were free from recurrent disease at the last follow-up (72.1 vs. 82.5%; p<0.001). The stage-specific 5-year DFS did not differ between the young and older cohorts. Only stage and the need for chemotherapy independently predicted poor DFS. Conclusions: Young patients present at a later stage and a greater proportion develop distant disease recurrence over time. However, their stage-specific oncologic outcomes appear similar to those in older-onset patients. To have the greatest impact on long-term oncologic outcomes in patients with young-onset rectal cancer, future interventions should target strategies to diagnosis rectal cancer earlier, and once diagnosed, closer surveillance for recurrence may be warranted. Society of Surgical Oncology, 2011 You Y. Division of Colorectal Surgery, Mayo Clinic, Rochester, MN, USA aut Dozois Eric Division of Colorectal Surgery, Mayo Clinic, Rochester, MN, USA aut Boardman Lisa Division of Gastroenterology, Mayo Clinic, Rochester, MN, USA aut Aakre Jeremiah Division of Biostatistics, Mayo Clinic, Rochester, MN, USA aut Huebner Marianne Division of Biostatistics, Mayo Clinic, Rochester, MN, USA aut Larson David Division of Colorectal Surgery, Mayo Clinic, Rochester, MN, USA aut Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2469-2476 1068-9265 18:9<2469 2011 18 10434 https://doi.org/10.1245/s10434-011-1674-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1674-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- You Y. Division of Colorectal Surgery, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Dozois Eric Division of Colorectal Surgery, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Boardman Lisa Division of Gastroenterology, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Aakre Jeremiah Division of Biostatistics, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Huebner Marianne Division of Biostatistics, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Larson David Division of Colorectal Surgery, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2469-2476 1068-9265 18:9<2469 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer