Prognosis poor for pediatric, adolescent patients with colon cancer
(HealthDay)—Patients with colon cancer who are younger than 25 years have a higher risk for death compared with older adults, according to a retrospective review published in the April issue of the Journal of the American College of Surgeons.
Andrea A. Hayes-Jordan, M.D., from the UNC School of Medicine, and colleagues conducted a retrospective review of pediatric and adolescent patients with colon cancer who were younger than 25 years and were treated between 1991 and 2017. The authors compared overall survival (OS) and recurrence-free survival (RFS) in the younger patients to survival in a prospectively maintained database of adult patients.
The researchers found that among 94 pediatric patients and 765 adult patients, three-year OS rates were 41.92 and 90 percent, respectively, and three-year RFS rates were 32 and 78 percent, respectively. Pediatric patients with stage 2, stage 3, and stage 4 disease had significantly worse five-year OS and five-year RFS. According to the results of a multivariate analysis, pediatric and adolescent patients also had a higher risk for recurrence or death compared with adult patients (hazard ratio, 2.312). Pediatric patients were also found to have more peritoneal metastasis.
"Stage for stage, children fare five to six times worse with treatment. So, a child with stage 4 disease has a six-times higher chance of dying than an adult with the same stage of cancer," Hayes-Jordan said in a statement. "Children are not small adults. They should be treated with independent thought and careful evaluation."
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