e14694 Background: Recent years have witnessed a trend towards an increase in incidence of rectal cancers in young adults both in western and asian populations. It has been noted that these cancers are more aggressive and associated with poorer outcomes. Methods: We conducted a retrospective analysis of young adults (age ≤ 40 years) with rectal cancers treated at our institute from 2007 to 2012. Information regarding stage, histology, treatment and outcomes were collected from patient records. Patients/family members were contacted for information regarding demographic, socioeconomic, dietary habits and occupational parameters. Disease free and overall survival was analyzed by Kaplan Meier estimates using the SPSS version 20. Results: A of total of 153 cases of rectal cancer were treated between 2007 to 2012 of which 48 patients (31%) were ≤ 40 years of age. Median age at presentation for the younger patients (≤40 years) was 30 years. There were 29 males and 19 females. None of these patients had a positive family history and no synchronous cancers were detected. Six patients were agricultural laborers and four worked in coal or cement factories. 23% of patients hailed from the coastal agricultural belt. At presentation, 41 patients had locally advanced disease and 7 had distant metastases. 25 patients received neoadjuvant chemoradiation, 17 underwent surgery and adjuvant chemoradiation and 6 were treated with palliative intent. Four patients progressed during treatment and eight had recurrent disease during follow up. Median overall survival (OS) was 21 months. 5-year OS was 37.5%. On multivariate analysis, poorly differentiated/mucinous tumors were associated with worse survival (p=0.01). Conclusions: 2-10% of colorectal cancers are reported to occur in young adults with many showing a familial association. In our series we had a higher proportion of young adults with sporadic cancers. Various occupational and environmental factors may be associated with these cancers. They are often detected in late stages and are associated with an aggressive course and unfavorable outcomes; hence early detection is of vital importance. Towards this end, identification of risk factors and screening programs need to be carried out.
Neoadjuvant Chemoradiation in Locally Advanced Carcinoma Rectum-A Tertiary Cancer Center Study