International Journal of Research in Oncology
Open AccessRetrospective Analysis of Rectal Cancer: Late Versus Early Onset (RELEO study)
Authors: María Valero Revert, David Sánchez Garcia, Mariano Martinez Marín, Beatriz Grau Mirete, Cristina Bernabé Martinez, Elena Navarro Vicente, Marta Hernández Sáez, María Orengo López, Alejandro Moya Martinez, Francisco Pelegrín Mateo, Elena Asensio Martinez, Javier Gallego Plazas.
Abstract
Background: The incidence of early-onset gastrointestinal cancer, particularly rectal cancer, is rising globally. Differences in disease presentation, treatment and outcomes in this population compared to older patients merits attention in the context of increasing aging.
Methods: RELEO studied rectal cancer patients consecutively treated in the Medical Oncology Department of Elche University and Vega Baja Hospitals between january 2010 and december 2023 in order to evaluate aspects related to the epidemiology, disease presentation, diagnosis and characteristics, as well as the therapeutic strategy and its results in young (70 years).
Results: 765 patients with rectal cancer were included for the global population analysis. For the stage-matched comparison, 51 patients under 50 years of age and 102 (1:2) of the 292 patients over 70 years of age were included. Rectal adenocarcinoma in people under 50, compared to those over 70, was not associated with differential risk factors detectable in anamnesis, had neither particular location in the rectum nor more advanced clinical stage at diagnosis, and was not associated to worse prognosis. Patients under 50 years of age, compared to patients over 70, had less comorbidities (p < 0.05) better perfomancce status (p<0.001), and more symptoms at diagnosis [abdominal pain (41.2% vs. 24.5%; p<0.05), rectal bleeding (86.3% vs. 70.6%; p<0.05)]. Treatment was more intense in patients under 50, in both localized (neoadjuvant, p<0.001; adjuvant, p=0.033) and advanced disease (chemotherapy use, p<0.001; intensity, p<0.001; lines of chemotherapy, p<0.001), with statistically significant longer overall survival in stage III [76.0 (31.0-114.0) vs 37.0 months (22.0-83.0); p=0.022] and IV patients [28.5 (19.8-47.0) vs 8.5 months (3.8-15.0); p=0.004].
Conclusion: RELEO showed similar disease profile of rectal cancer regardless of age, with more fragility in older patients, conditioning treatment and survival. Further better adjusted studies are appropiate to clarify impact of age on rectal cancer.
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