Colorectal cancer in the very young: A comparative study of tumor markers, pathology and survival in early onset and adult onset patients Journal Article
| Authors: | Khan, S. A.; Morris, M.; Idrees, K.; Gimbel, M. I.; Rosenberg, S.; Zeng, Z.; Li, F.; Gan, G.; Shia, J.; LaQuaglia, M. P.; Paty, P. B. |
| Article Title: | Colorectal cancer in the very young: A comparative study of tumor markers, pathology and survival in early onset and adult onset patients |
| Abstract: | Introduction Colorectal cancer (CRC) diagnosed before age 30 years is a fatal disease whose biology remains poorly understood. To understand its pathogenesis, we compared molecular and clinical data in surgically treated early-age onset and adult onset patients. Materials and Methods Clinical data and tumor tissue were collected retrospectively for 94 patients with early-age onset CRC (age ≤ 30 years) and compared to 275 adult CRC patients (age ≥ 50 years). Tumor morphology, microsatellite instability (MSI) and stability (MSS), KRAS and BRAF mutations, and mismatch repair (MMR) expression (MSH2, MLH1, MSH6, PMS2) were assessed. Results Early-age CRC was distinguished from adult CRC by advanced stage presentation (P < 0.001), frequent high grade cancers (P < 0.001), and poor prognosis (P < 0.001). MSI was associated with favorable survival and MMR loss in both groups. Compared to adults, MSI in early-onset CRC was more prevalent (P < 0.01), not tightly linked to MLH1/PMS2 loss, and never associated with BRAFV600E mutations (P < 0.01). MSS/BRAFV600E genotype had poor prognosis and was more prevalent in early-age CRC (9% vs. 3%). Discussion Specific genetic subtypes are found at different frequencies in early-age onset and adult onset CRC. Complete absence of the indolent MSI/BRAFV600E genotype and enrichment in the unfavorable MSS/BRAFV600E genotype help explain the poor prognosis of early onset CRC. © 2016 |
| Keywords: | braf; msi; early onset colorectal cancer |
| Journal Title: | Journal of Pediatric Surgery |
| Volume: | 51 |
| Issue: | 11 |
| ISSN: | 0022-3468 |
| Publisher: | W.B. Saunders Co-Elsevier Inc. |
| Date Published: | 2016-11-01 |
| Start Page: | 1812 |
| End Page: | 1817 |
| Language: | English |
| DOI: | 10.1016/j.jpedsurg.2016.07.015 |
| PROVIDER: | scopus |
| PUBMED: | 27558481 |
| PMCID: | PMC5312708 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 November 2016 -- Source: Scopus |
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