학술논문
Clinico-Pathological Features, Outcomes and Impacts of COVID-19 Pandemic on Patients with Early-Onset Colorectal Cancer: A Single-Institution Experience.
Document Type
Article
Author
Martinez-Perez, Daniel; Viñal, David; Peña-Lopez, Jesús; Jimenez-Bou, Diego; Ruiz-Gutierrez, Iciar; Martinez-Recio, Sergio; Alameda-Guijarro, María; Rueda-Lara, Antonio; Martin-Montalvo, Gema; Ghanem, Ismael; Custodio, Ana Belén; Trilla-Fuertes, Lucia; Gamez-Pozo, Angelo; Barbachano, Antonio; Rodriguez-Cobos, Javier; Bustamante-Madrid, Pilar; Fernandez-Barral, Asuncion; Burgos, Aurora; Prieto-Nieto, Maria Isabel; Pastrian, Laura Guerra
Source
Subject
*CLINICAL pathology
*EVALUATION of medical care
*CANCER patient psychology
*HEALTH facilities
*METASTASIS
*COLORECTAL cancer
*TUMOR classification
*AGE factors in disease
*RESEARCH funding
*STAY-at-home orders
*COVID-19 pandemic
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Language
ISSN
2072-6694
Abstract
Simple Summary: The rising incidence of colorectal cancer (CRC) among young patients (≤50 years) is alarming. We included all patients with pathologically confirmed diagnoses of CRC at Hospital Universitario La Paz from October 2016 to December 2021. A total of 1475 patients diagnosed with CRC were included, eighty (5.4%) of whom had EOCRC. Aggressive pathological features, such as T, N stage and metastatic presentation at diagnosis; perineural invasion; tumor budding; high-grade tumors; and signet ring cell histology, were higher in the early-onset group. Patients with metastatic EOCRC HAD a significantly longer median OS than the older cohort. Regarding COVID-19 pandemic, more patients with COVID-19 were diagnosed with metastatic disease (61%) after the lockdown. The long-term consequences of COVID-19 are yet to be determined. Background: The rising incidence of colorectal cancer (CRC) among young patients is alarming. We aim to characterize the clinico-pathological features and outcomes of patients with early-onset CRC (EOCRC), as well as the impacts of COVID-19 pandemic. Methods: We included all patients with pathologically confirmed diagnoses of CRC at Hospital Universitario La Paz from October 2016 to December 2021. The EOCRC cut-off age was 50 years old. Results: A total of 1475 patients diagnosed with CRC were included, eighty (5.4%) of whom had EOCRC. Significant differences were found between EOCRC and later-onset patients regarding T, N stage and metastatic presentation at diagnosis; perineural invasion; tumor budding; high-grade tumors; and signet ring cell histology, with all issues having higher prevalence in the early-onset group. More EOCRC patients had the RAS/ BRAF wild type. Chemotherapy was administered more frequently to patients with EOCRC. In the metastatic setting, the EOCRC group presented a significantly longer median OS. Regarding the COVID-19 pandemic, more patients with COVID-19 were diagnosed with metastatic disease (61%) in the year after the lockdown (14 March 2020) than in the pre-pandemic EOCRC group (29%). Conclusions: EOCRC is diagnosed at a more advanced stage and with worse survival features in localized patients. More patients with EOCRC were diagnosed with metastatic disease in the year after the COVID-19 pandemic lockdown. The long-term consequences of COVID-19 are yet to be determined. [ABSTRACT FROM AUTHOR]