Abdullah KISAOĞLU, Özgür Hakan BULUT, Ercan KORKUT, Sabri Selçuk ATAMANALP, Gürkan ÖZTÜRK, Bünyami ÖZOĞUL, Mehmet İlhan YILDIRGAN

Evaluation of colorectal cancers in young patients

Amaç: Genç hastalarda kolorektal kanserler genel popülasyona göre daha az görülmesine rağmendaha kötü prognoza sahiptir. Son yıllar içerisinde bu yaş grubunda kolorektal kanserlerin görülmesıklığı artmaktadır. Biz bu çalışmada kliniğimizde takip ve tedavisi yapılan genç kolorektalkanserli hastaların özelliklerini ve sonuçlarımızı literatür ışığında inceledik.Yöntem: Kliniğimizde Ocak 2005-Eylül 2013 tarihleri arasında 40 yaş altındaki 39 hastanınkayıtları retrospektif olarak incelendi. Bu hastaların yaşı, cinsiyeti, tümörün yerleşim yeri,operasyonun şekli ve tümörün patolojik özellikleri kaydedildi.Bulgular: Hastaların 19u (%48,7) kadın, 20si (%51,3) erkek ve ortalama yaş 32,6 (19-39) idi.Otuzdördü (%87,2) elektif, 5i (%12,8) acil opere edilmişti. Tümör en fazla rektumda yerleşik idi(%41,0; n=16). Tümörün sağ kolonda olduğu 13 (%33,3) hastanın tamamına sağ hemikolektomi,rektumda yerleşen tümörlere de en fazla low anterior rezeksiyon uygulanmış, toplam 7 hastayastoma açılmıştı. Patolojik inceleme sonucunda 17 (%43,6) hastada müsinöz adenokarsinomgörüldü.Sonuç: Genç kolorektal kanserli hastalarda rektum kanserleri daha sık görülmekte ve genellikleileri evrede tanı konulmaktadır. Bu nedenle bu hasta grubunda kolorektal kanser şüphesi uyandıranşikayetler titizlikle irdelenmeli ve ileri tetkik yöntemlerine başvurulmalıdır.

Genç hastalarda kolorektal kanserlerin değerlendirilmesi

Objective: Even though the colorectal cancer is less common in young patients, it has a worseprognosis. The incidence of colorectal cancer in this age group is increasing in recent years. In thisstudy we investigated young patients with colorectal cancer, whose follow-ups and treatmentswere performed in our clinic, according to the literature.Method: In our clinic the records of 39 patients under 40 years of age were examined betweenJanuary 2005 and September 2013 retrospectively. Age and gender of the patients, tumorlocalizations, the shape of the operation and the tumor pathological features were recorded.Results: 19 patients (48.7%) were female, 20 (51.3%) were male and mean age was 32.6 (19-39)years. 34 patients (87.2%) operated electively and 5 patients (12.8%) had emergency surgery. Thelocalization of the tumor was mostly in the rectum (41.0%, n = 16). For 13 (33.3%) patients, whohave the tumor localized in the right column, right hemicolectomy was performed. For patients,who have the tumor localized in the rectum, mostly low anterior resection was performed andtotally for 7 patients, a stoma was opened. Pathological investigation revealed mucinous adenocar- cinoma in 17 (43.6%) patients.Conclusion: Rectal cancer is more common in young patients with colorectal cancer and is oftendiagnosed at an advanced stage. Therefore in this patient group, complaints, which cause suspicionof colorectal cancer, should be examined carefully and advanced inspection methods should beperformed.

PDF

___

1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, Thun MJ. Cancer statistics. CA Cancer J Clin 2008; 58: 71-96.
2. OConnell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY. Do young colon cancer patients has worse outcomes? World J Surg 2004; 28: 558-62.
3. Keswani SG, Boyle MJ, Maxwell JP 4th, Mains L, Wilks SM, Hunt JP, O'Leary JP. Colorectal cancer in patients younger than 40 years of age. Am Surg 2002; 68: 871-6.
4. Umpleby HC, Williamson RC. Carcinoma of the large bowel in the first four decades. Br J Surg 1984; 71: 272-7.
5. Chung YF, Eu KW, Machin D, Ho JM, Nyam DC, Leong AF, Ho YH, Seow-Choen F. Young age is not a poor prognostic marker in colorectal cancer. Br J Surg 1998; 85: 1255-9.
6. Adloff M, Arnaud JP, Schloegel M, Thibaud D, Bergamaschi R. Colorectal cancer in patients under 40 years of age. Dis Colon Rectum 1986; 29: 322-5.
7. O'Connell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY. Rates of colon and rectal cancers are increasing in young adults. Am Surg 2003; 69: 866-72.
8. O'Connell JB, Maggard MA, Livingston EH, Yo CK. Colorectal cancer in the young. Am J Surg 2004; 187: 343-8.
9. Shemesh-Bar L, Kundel Y, Idelevich E, Sulkes J, Sulkes A, Brenner B. Colorectal cancer in young patients in Israel: A distinct clinicopathological entity? World J Surg 2010; 34: 2701-9.
10. Berut M, Mik M, Kędzia-Berut R, Kujawski R, Trzciński R, Dziki Ł, Dziki A. Colorectal cancer in young and elderly patients. Pol Przegl Chir 2013; 85: 446-51.
11. Ben-Ishay O, Brauner E, Peled Z, Othman A, Person B, Kluger Y. Diagnosis of colon cancer differs in younger versus older patients despite similar complaints. Isr Med Assoc J 2013; 15: 284-7.
12. Minardi AJ Jr, Sittiq KM, Zibari GB, McDonald JC. Colorectal cancer in the young patient. Am Surg 1998; 64: 849-53.
13. Leff DR, Chen A, Roberts D, Grant K, Western C, Windsor AC, Cohen CR. Colorectal Cancer in the Young Patient. Am Surg 2007; 73: 42-7.
14. D'Onofrio GM, Tan EG. Is colorectal carcinoma in the young a more deadly disease? Aust N Z J Surg 1985; 55: 537-40.
15. Zbuk K, Sidebotham EL, Bleyer A, La Quaglia MP: Colorectal cancer in young adults. Semin Oncol 200936: 439-50.