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01 July 1997

Colorectal carcinoma in patients under 40 years of age: clinical presentation and early effects of treatment

Krzysztof Bielecki, Piotr Kamiński, Mirosław Klukowski, Andrzej W Włodarczyk

Med Sci Monit 1997; 3(4): CR499-503 :: ID: 501343

Abstract

During the years 1988 to 1995, 327 patients were treated for primary colorectal carcinoma; 15 (5.4%) of them (11 women, 4 men) were 26-40 years old, with a mean age of 30.8 years. The majority of tumors, 11 (73.3%) were found in the left colon. This group was retrospectively compared with the remaining 312 patients in order to find out whether there were any differences in clinical presentation and early effects of the treatment. Carcinoma of the transverse colon was more frequent in young adults (20%) than in patients over 40 years of age (5.7%). This difference was statistically significant. In one patient carcinoma occurred secondary to ulcerative colitis of a 10-year duration. In the remaining patients the time from the onset of symptoms and diagnosis of the disease to surgical treatment ranged from 2 weeks to 18 months (mean time=6.5 months). All patients received surgical treatment. Two (2) women were operated urgently because of an ileus. Fourteen (14) patients underwent resection procedures, most frequently anterior rectal amputation. Intestinal anastomosis was not performed in 3 adults. Ten (10) patients received surgical procedure as a definitive treatment. Postoperative complications occurred in 5 (33.3%) adults. None of the patients died. Most patients (60%) had carcinoma of C and D stages of progression according to the modified Dukes classification; there was a similar incidence of advanced carcinoma in older patients (56.4%). Poorly differentiated adenocarcinoma (33.3%) and mucinous carcinoma (20%) were more frequent in younger than older patients (16.9% and 5.4%, respectively). The difference in the occurrence of mucinous carcinoma was statistically significant. On the basis of our data, we may conclude that there are no significant differences in the clinical picture and natural history of colorectal carcinoma in patients of these two groups apart from a more frequent occurrence of mucinous carcinoma in young patients.

Keywords: large intestine, mucinous carcinoma, carcinoma in young patients

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750