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Mucinous colorectal carcinoma to predict poor outcome in young patients.

2016; Lippincott Williams & Wilkins; Volume: 34; Issue: 15_suppl Linguagem: Inglês

10.1200/jco.2016.34.15_suppl.e15076

1527-7755

Basem Soliman, Gamal Amira, Hesham Mohamed Hamza, Hamza Abbas Hamza, Ahmed Salem, Ashraf Elyamany, Ali Zedan, Mahmoud H. Elshoieby, Hussein Fakhry, Murad A. Jabir, Kareem Abu‐Elmagd,

Colorectal and Anal Carcinomas

e15076 Background: The prognostic significance of mucinous colorectal carcinoma (MC) is controversial, potentially due to heterogonous nature of populations studied. Clinically, we noticed that the young MC patients had more frequent and earlier recurrence compared to nom-mucinous colorectal cancer patients (NMC). We performed this study to compare the oncological outcome in young patients with MC and NMC. Methods: A single-institution prospectively maintained colorectal cancer database was queried for patients with colorectal adenocarcinoma (CRC) less than 40 years of age. Medical records were reviewed for clinicopathological characteristics, treatment, and oncologic outcomes. Patients with inflammatory bowel disease and hereditary colorectal cancer syndromes were excluded. The population was categorized as MC or NMC according to the presence of mucinous histology (extracellular mucin over 50%) on pathology reports. Results: We identified 84 patients who were younger than 40 years-old and underwent resection for CRC between 2003 and 2011. The mean age was 30 years and 50% were female. 44 patients (52.4%) had rectal cancer. 41 patients (48.8%) had MC histology and 43 (51%) had NMC histology. MC patients were younger (28 ± 6 years vs. 31.5 ± 6 years, p = 0.01), and MC occurred more often in men (65% vs 35%, p = 0.02). The MC and NMC study populations were not statistically different in terms of tumor site, pathological stage, T stage, N stage, m stage, differentiation degree, or the use of neoadjuvant and adjuvant therapy. MC tumors were larger in size (4.9 ± 2.8 cm vs. 3.4 ± 2.7 cm, p = 0.01) and were more likely to have angiolymphathic invasion (27.8% vs. 7.7%, p < 0.001). Five-year disease free survival (DFS) was (20.2% vs. 38.3%, p = 0.006) and five-year overall survival (OS) was (24.7% vs 47.8%, p = 0.002) for young patients with MC compared to NMC. Multivariate analysis revealed that the mucinous pathology was independent negative prognostic factor for both DFS and OS. Conclusions: Mucinous differentiation in young CRC patients is an independent poor prognostic factor predicting more frequent and earlier recurrence and reduced overall survival. Physicians need to be attentive of this association and possible novel treatment options should be explored.