부산대학교 도서관

Worldwide, colorectal cancer (CRC) is the third most common cancer in both males and females, preceded by breast and lung tumors. It is also the second cause of cancer-related deaths. [...]
Aim: The incidence of colorectal tumors in young patients has been rising lately, and current investigations focus on the causes and prognosis in these patients. The objective of this publication is to analyze the results of the surgical treatment and tumor stages in young patients and compare them to those in older individuals. Method: A retrospective analysis of patients undergoing surgery for colorectal adenocarcinoma during 2015-2020 in a single institution was performed. Patients were divided into two categories, early-onset colorectal cancer (EOCRC) (younger than 50 years old) and average-onset CRC (AOCRC) (those on age for CRC screening), focusing on disease stage and postoperative outcomes. Results: Two hundred and seven patients were included: 32 in the EOCRC group and 175 in the AOCRC group. The median age was 42.10 years [standard deviation (SD) =5.74] and 65.38 years (SD =7.19), respectively. Dyslipidemia was more prevalent in the AOCRC group. The EOCRC group had more tumors in the upper rectum (28.13% vs. 8%; p=0.001) and transverse colon (21.88% vs. 10.29%; p=0.06) and higher rates of complications (43.75% vs. 28%; p=0.07) and reoperations (18.75 vs. 7.43%; p=0.04). Moreover, major complications were more frequent in younger patients. The EOCRC group had significantly more stage IV tumors (18.75% vs. 5.13%; p=0.01), and 46.86% of patients in this group had an advanced disease at the time of surgery. Conclusion: Patients in the EOCRC group are diagnosed at more advanced stages and show differences in tumor location. Complications including the need for reoperation are more frequent in this group. Keywords: Colorectal adenocarcinoma, early onset, screening strategies, colonoscopy, advanced stage Amac: Son zamanlarda genc hastalarda kolorektal tumor insidansi artmakta olup, guncel arastirmalar bunun nedenlerini ve prognozunu belirlemeye yoneliktir. Bu derlemenin amaci, genc hastalarda cerrahi tedavi sonuclarini ve tumor evrelerini analiz etmek ve bunlari yasli bireylerle karsilastirmaktir. Yontem: Bu derlemede, 2015-2020 yillari arasinda tek bir kurumda kolorektal adenokarsinom ameliyati geciren hastalarin retrospektif bir analizi yapildi. Hastalar iki kategoriye ayrilarak hastalik evresine ve ameliyat sonrasi sonuclara odaklanildi: Elli yasindan genc hastalardaki erken baslangicli kolorektal kanserler (EOCRC) ve kolorektal kanser taramasinin yapildigi yastaki hastalarda ortaya cikan ortalama baslangicli kolorektal kanserler (AOCRC). Bulgular: Otuz ikisi EOCRC grubunda olmak uzere 207 hasta dahil edildi. Ortanca yas sirasiyla 42,10 [standart sapma (SS) =5,74] ve 65,38 (SS =7,19) idi. AOCRC grubunda dislipidemi daha yaygindi. EOCRC grubunda daha fazla ust rektum (%28,13'e karsi %8, p=0,001) ve transvers kolon (%21,88'e karsi %10,29, p=0,06) tumorleri vardi, komplikasyon oranlari (%43,75'e karsi %28, p=0,07) ve yeniden operasyon oranlari (18,75'e karsi %7,43, p=0,04) daha yuksekti. Ayrica, major komplikasyonlar genc hastalarda daha sikti. EOCRC grubu onemli olcude daha fazla evre IV tumor ile iliskili idi (%18,75'e karsi %5,13, p=0,01) ve bu hastalarin %46,86'sinda ameliyat sirasinda ilerlemis hastalik mevcuttu. Sonuc: Erken baslangicli kolorektal kanserler hastaligin daha ileri evrelerinde teshis edilir ve tumor yerlesiminde farkliliklar gosterir. Bu grupta tekrar ameliyat gereksinimi gibi komplikasyonlar daha sik gorulmektedir. Anahtar Kelimeler: Kolorektal adenokarsinom, erken baslangic, tarama stratejileri, kolonoskopi, ileri evre