scholarly journals Clinical Features and Outcome of Sporadic Colorectal Carcinoma in Young Patients: A Cross-Sectional Analysis from a Developing Country

ISRN Oncology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Muhammad Nauman Zahir ◽  
Eisha Mahpara Azhar ◽  
Sobia Rafiq ◽  
Kulsoom Ghias ◽  
Munira Shabbir-Moosajee
Keyword(s):  
Colorectal Carcinoma ◽  
Rectal Carcinoma ◽  
Early Onset ◽  
Multivariable Analysis ◽  
Young Patients ◽  
Retrospective Chart Review ◽  
Cross Sectional ◽  
Female Ratio ◽  
Colon Cancers ◽  
Rectal Cancers

Background. Early onset colorectal carcinoma (CRC) is rare and has been hypothesized to be a biologically and clinically distinct entity personifying aggressive disease and worse survival. Methods. Data for 131 patients was collected by retrospective chart review. Cox proportional hazard model was used to compute prevalence ratios and 95% confidence intervals. Results. Early onset sporadic CRC accounted for 32% of all CRC treated in the specified time period. The mean age was 33.3±7.9 years and the male to female ratio was 2:1. Colon and rectal cancers accounted for 55% and 45% of patients, respectively. 96% of rectal carcinoma patients received appropriate therapy as opposed to 65% of colon cancers. On multivariable analysis, appropriate reception of therapy (PR 4.99; 95% CI, 1.21–20.6) and signet ring morphology (PR 2.40; 95% CI, 1.33–4.32) were significantly associated with rectal cancers as opposed to colon cancer. Kaplan-Meier analysis revealed a trend towards inferior survival for rectal carcinoma 2 years after diagnosis. Conclusion.A high prevalence of early onset CRC was noted in the study. A trend towards inferior survival was seen in patients with rectal cancer. This finding raises the possibility of rectal carcinoma being an aggressive subset of young CRC.

Clinical features and outcome of sporadic colorectal carcinoma in young adults: A single center, cross sectional analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14680-e14680
Author(s):  
Muhammad Nauman Zahir ◽  
Eisha Mahpara ◽  
Sobia Rafiq ◽  
Kulsoom Ghias ◽  
Munira Shabbir-Moosajee
Keyword(s):  
Colorectal Carcinoma ◽  
Rectal Carcinoma ◽  
Survival Data ◽  
Early Onset ◽  
Care Center ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Cross Sectional ◽  
Female Ratio ◽  
Significant Difference

e14680 Background: Early onset colorectal carcinoma (CRC), defined as CRC at age below 45 years is rare. However, an increasing incidence has been noted in Southeast Asia. It is hypothesized to be a biologically and clinically distinct entity personifying aggressive disease and a worse survival. Data on this subject is scarce from this part of the world and hence our objective was to study the clinical presentation and outcome of early onset sporadic CRC in patients at a single tertiary care center in Pakistan. Methods: Data was collected by a retrospective chart review. 131 patients were found eligible for the period between January 1, 2004 and December 31, 2011. A pre-designed and coded questionnaire was used and analysis was done using SPSS. Cox proportional hazard model was used to compute prevalence ratios. Results: Early onset sporadic CRC accounted for 32% of all CRC treated in the specified time period. Colon and rectal cancers accounted for 55% and 45% of patients respectively. The median age was 35 years (range 16-45 years) and the male to female ratio was 2:1. 74% of patients presented with advanced stage disease [stages III (45%) and IV (29%)]. On comparison, bleeding per rectum, signet ring morphology, stage and grade of tumor were found to be statistically significant for the rectal cancer group on a univariate analysis. 93% of rectal carcinoma patients received appropriate surgery and/or neoadjuvant/adjuvant therapy as opposed to 69% of colon cancers. Median survival was 19 months (range 0-112.5 months). However, Kaplan-Meier analysis revealed a trend towards an inferior survival for rectal carcinoma 2 years after initial diagnosis (p=0.56). Conclusions: Higher incidence of early onset CRC is noted in our population as compared to the western literature. Rectal carcinoma accounts for almost half the patients in this young CRC population. This group was found to have a higher frequency of poor prognostic factors. However, we have noted a similar 2 year survival between the 2 groups, with a trend towards an inferior prognosis with longer followup. It is possible that a larger sample size may have elucidated a statistically significant difference between the two groups.

scholarly journals Colonoscopic Review and Surgical Approach in the Management of Colorectal Carcinoma–A Retrospective Study of 50 cases

2019 ◽  
Vol 11 (2) ◽  
pp. 36-40
Author(s):  
Md Ershad Ul Quadir ◽  
Munshi Md Mojibur Rahman ◽  
Md Mahbubur Rahman
Keyword(s):  
Colon Cancer ◽  
Weight Loss ◽  
Retrospective Study ◽  
Early Detection ◽  
Colorectal Carcinoma ◽  
Rectal Carcinoma ◽  
Palliative Therapy ◽  
Treatment Modalities ◽  
Definitive Treatment ◽  
Female Ratio

Introduction: There is no exact statistics about the incidence of colorectal cancer in Bangladesh. According to National Cancer Institute, London, it is the 2nd most common cancer affecting more than 30,000 people in each year. As many patients with colon cancer do not develop symptoms until it is advanced and detection in early stage can only be achieved by screening of asymptomatic person. Maximum patients present lately with distance metastases when there is nothing to treat except palliative therapy. Objectives: To identify the risk factors, early symptoms, signs, treatment modalities, operative outcome, morbidity and mortality rate. Materials and Methods: This retrospective study was carried out at CMH Dhaka during August 2002 to August 2004. A total of 50 patients were taken as study sample. All the patients were admitted in different surgical units of CMH Dhaka for surgical treatment. Detailed history were taken on admission by a questionnaire and examined thoroughly and findings regarding Anaemia, Jaundice, Dehydration, Oedema, Lymphadenopathy, Nutritional status and abnormal signs like ascites, distension, rigidity, organomegaly recorded. Digital rectal examination were done in all cases and finally examined by Proctoscope, Sigmoidoscope and with Colonoscope. FOBT (Fecal Occult Blood Test), serum tumour marker was also assessed. Results: Out of 50 cases 22 were rectal carcinoma and next common site was caecum and number was 10. There was a variation in the sex ratio. Out of 50 cases 33 were male and 17 were female. The highest incidence was among people of 6th decade (28%) and next highest was in 4th decade (24%). Majority of patient with right colon cancer presented with abdominal pain 12 out of 22 cases (56%) and weight loss 15 cases (68%). For left colon cancer commonest symptom was weight loss and weakness and altered bowel habit. Almost all cases with rectal carcinoma presented with bleeding per rectum. Conclusion: About 50% of lesions were found in recto-sigmoid junction and male: female ratio was 1.9:1. All efforts and modern technology should be applied for early detection and treatment. The survival rate is usually very poor in rectal carcinoma. In this study most of the cases were subjected to post operative Chemo and Radiotherapy, but more were treated with neoadjuvant chemoradiation for down staging. The need for early detection of Colorectal Carcinoma (CRC) should be stressed in the form of screening patient awareness and understanding about symptomatology. Early diagnosis and definitive treatment are thereby increasing expectation of higher survival and better prognosis in patient of colorectal carcinoma. Journal of Armed Forces Medical College Bangladesh Vol.11(2) 2015: 36-40

scholarly journals A STUDY ON PRESENTATION AND BEHAVIOR OF COLO-RECTAL CARCINOMA IN JHARKHAND

2020 ◽  
pp. 1-2
Author(s):  
Navin Kumar Saha ◽  
Mritunjay Sarawgi ◽  
C.P. Sinha ◽  
Krishan Kumar
Keyword(s):  
Rectal Carcinoma ◽  
Young Patients ◽  
Rectal Biopsy ◽  
Late Presentation ◽  
Rectal Pain ◽  
Bowel Habits ◽  
Loss Of Weight ◽  
Age Variations ◽  
Rectal Cancers ◽  
And Behavior

Introduction: Colo-rectal carcinoma is most frequent neoplasm of Western countries. It is 3rd most common in men and 2nd most common in women. The Aim of this study is to know different presentations and age variations and its method of diagnosis and management. Materials and methods: This is a observational study including 25 patients presented in the Emergency and OPD of RIMS, Ranchi with complaints of bleeding PR, alteration of bowel habits, rectal pain and discharge, incontinence, abdominal pain and distention and loss of weight. Results: Most common age of presentation is 40-50 years, most commonly involving men. Most common presentation is alteration of bowel habits followed by bleeding PR. Diagnosis was mostly made by CECT whole abdomen and colonoscopic /Rectal biopsy. Follow-up was done by CEA levels. Conclusion: There is increased incidence of colo-rectal carcinoma in young patients and there is tendency of late presentation of colo-rectal cancers.

Occurrence and risk factors of uveitis in juvenile psoriatic arthritis: Data from a population-based nationwide study in Germany

2022 ◽  
pp. jrheum.210755
Author(s):  
Karoline Walscheid ◽  
Kai Rothaus ◽  
Martina Niewerth ◽  
Jens Klotsche ◽  
Kirsten Minden ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psoriatic Arthritis ◽  
Early Onset ◽  
Late Onset ◽  
Multivariable Analysis ◽  
Population Based ◽  
Ocular Involvement ◽  
Cross Sectional ◽  
Dmard Treatment ◽  
Clinical Difference

Objective Data on uveitis in juvenile psoriatic arthritis (JPsA), a category of juvenile idiopathic arthritis (JIA), are scarce. We describe prevalence and risk factors for JPsA-associated uveitis (JPsA-U). Methods Cross-sectional data from the National Pediatric Rheumatological Database (from 2002 to 2014) were used to characterize JPsA-U and assess risk factors for uveitis development. Results Uveitis developed in 6.6% of 1862 JPsA patients. JPsA-U patients were more frequently female (73.0 vs 62.9%, p=0.031), ANA positive (60.3 vs 37.0%, p<0.001), younger at JPsA onset (5.3 ± 4.1 vs 9.3 ± 4.4 years, p<0.001), and received DMARD (disease modifying antirheumatic drug) treatment significantly more frequently than JPsA patients without uveitis. On multivariable analysis of a subgroup of 655 patients, mean cJADAS during study documentation was significantly associated with uveitis development. Children with early onset of JPsA were significantly more frequently ANA positive (48.4% vs 35.7% for those younger than 5 years at JPsA onset versus those aged 5 years and older, p<0.001), less often affected by skin disease (55.3% vs 61.0%, p=0.032), but more frequently by uveitis (17.3% vs 3.8%, p<0.001), and required DMARD treatment more frequently (52.9% vs 43.8%, p<0.001). Conclusion The characteristics of JPsA patients developing uveitis are similar to those of patients with uveitis in other JIA categories, such as oligoarticular JIA. Especially those children with early onset of JPsA seem to be at a higher risk for ocular involvement. Our data support the notion of a major clinical difference between those patients with early versus late onset of JPsA.

Evaluation of Demographic and Clinical Presentation of Colorectal Carcinoma in Rajshahi Region

2020 ◽  
Vol 33 (2) ◽  
pp. 15-19
Author(s):  
Monira Parveen ◽  
SM Asafudullah ◽  
Md Nowshad Ali ◽  
Khadiza Khanom ◽  
Arefa Sultana ◽  
...  
Keyword(s):  
Colorectal Carcinoma ◽  
Bowel Habit ◽  
Cross Sectional ◽  
Female Ratio ◽  
Male Predominance ◽  
Face To Face ◽  
Medical College ◽  
Presenting Symptoms ◽  
Group A ◽  
Group B

This cross-sectional, descriptive, observational study was carried out for a period of 24 months from January 2014 to December 2015 in the Department of Pathology and Department of Surgery, Rajshahi Medical College, Rajshahi for evaluation of clinical and histological presentation of colorectal carcinoma patients in total fifty four patient. Data were collected by face to face interview, clinical examination. The study revealed that the colorectal carcinoma was highest in the 5th and 6th decade and rectal area (46.3%) and male predominance was observed with male to female ratio being 3:2. Abdominal pain (61.1%), weight loss (61.1%), per rectal bleeding (57.4%), altered bowel habit (24.1%) and melena (24.1%) are the main presenting symptoms. In terms of ABO blood grouping, blood group ‘B’ was found predominant (44.4%), followed by group ‘A’ (24.1%), group ‘AB’ (14.8%) and group ‘O’ (16.7%). TAJ 2020; 33(2): 15-19

scholarly journals Serum CA 19.9 as a Tumour Marker in Colorectal Cancer Staging- An Experimental Study

2020 ◽  
Vol 33 (1) ◽  
pp. 35-40
Author(s):  
Monira Parveen ◽  
Shah Md Badruddoza ◽  
SM Asafudullah ◽  
Khadiza Khanom ◽  
Arefa Sultana ◽  
...  
Keyword(s):  
Colorectal Carcinoma ◽  
Early Stage ◽  
Cancer Staging ◽  
Tumour Marker ◽  
Enzyme Linked Immunosorbent Assay ◽  
Advanced Stage ◽  
Cross Sectional ◽  
Female Ratio ◽  
Male Predominance ◽  
Preoperative Serum

This cross-sectional, descriptive observational study was carried out for a period of 24 months from January 2014 to December 2015 in the Department of Pathology and Department of Surgery, Rajshahi Medical College, Rajshahi for estimation of serum 19-9 level in total fifty four patients. Histopathological Staging was correlated with the preoperative values of serum CA 19-9 level. Data were collected by face to face interview, clinical examination and findings of laboratory investigations. Preoperative serum CA 19-9 levels were estimated by Enzyme Linked Immunosorbent Assay (ELISA) Method. The study revealed that the colorectal carcinoma was highest in the 5th and 6th decade and rectal area (46.3%) and male predominance was observed with male to female ratio being 3:2. A higher incidence of abnormal CA 19-9 level was found in Dukes’ D (100%) and Dukes’ C (84%) diseases than in Dukes’ B (76%) and Dukes’ A (75%) stages. The sensitivity of CA 19-9 in correctly detecting advanced stage CRC carcinoma from those who had early stage of the disease is (36/44) × 100 = 81.8% and its specificity in correctly excluding those who did not have advanced disease is (2/10) × 100 = 20%. The overall diagnostic accuracy is calculated to be (36 + 2)/54 = 70.37%. Regarding diagnostic values for colorectal carcinoma elevated level of serum CA 19-9 can be considered as an important diagnostic tool for differentiating advanced stage of colorectal carcinoma from its early stage TAJ 2020; 33(1): 35-40

scholarly journals Incidence of Colorectal carcinoma in Young Population of Islamabad

2019 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Colorectal Carcinoma ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Undifferentiated Carcinoma ◽  
Young Population ◽  
Sectional Study ◽  
Cross Sectional ◽  
Surgical Ward ◽  
Male Patients ◽  
Gender Presentation

The Purpose of this study is to promote awareness concerning increased incidence of colorectal carcinoma in younger population and its clinical as well as pathological features compared to older patients. This cross sectional study was conducted from January 2017 to October 2017 in patients with diagnosis of colorectal carcinoma admitted through emergency or outpatient department to surgical ward of PIMS hospital of Islamabad. Data concerning age, gender, presentation, site of tumor, surgery performed and Dukes staging was used for analysis. Total numbers of patients screened were 250. Patients with colorectal carcinoma were 27. Male patients were 17(63%) and females were 10 (37%). Patients between the ages of 10-20 were 4(15%) out of these 2 were declared unfit for surgery because of widespread tumor within the abdomen as well as distant metastasis. There were 9 (33%) patients between the ages of 21 to 30 while among these 4 were inoperable because of widespread and undifferentiated carcinoma. Patients between the ages of 31 and 40 were 5 (19%), among these 2 were inoperable. The next category of patients was between the ages of 41 to 50, they were 4 (15%). There were 3 (11%) patients between the ages of 51 and 60, and 2 (7%) cases were between the ages of 61 to 70. Total 9 (33.3%) young patients were inoperable and they were of age 50 and below 50. Colorectal Carcinoma is more aggressive among young patients [1,2]. Total Stage D inoperable patients were 11(40.7%) and 18 (82%). Patients between the ages of 10 to 50 had left sided disease.

Rectal cancer in young patients: Clinicoepidemiologic profile and treatment outcomes.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4042-4042
Author(s):  
Pankaj. Goyal ◽  
Udip Maheshwari ◽  
Parveen Jain ◽  
Chaturbhuj Agrawal ◽  
Krushna A. Chaudhari ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Regression Analysis ◽  
Treatment Outcomes ◽  
Cancer Patients ◽  
Young Patients ◽  
Disease Stage ◽  
Female Ratio ◽  
Cox Regression Analysis ◽  
Younger Age ◽  
Rectal Cancers

4042 Background: Colorectal cancers are 3rd most common cause of cancer globally however studies of rectal cancers alone in younger patients are scarce. Rectal cancers in Asian patients present at a younger age and has an aggressive tumor biology. This study looks at rectal cancer in young patients, ≤30 years old, with the aim to report clinico-epidemiologic profile and treatment outcomes in this subgroup. Methods: Retrospective analysis was conducted at a tertiary care centre. Of total 845 rectal cancer patients between 2012-2017, 103 patients of young rectal cancers were enrolled. Kaplan Meier method was used for survival analysis and cox regression analysis was done to identify factors affecting survival. Results: Young rectal cancer patients constituted 12.2% of the total rectal cancer patients. Male: Female ratio was 2.3:1 and the mean age was 24.7 ± 3.9 years. Around 73.8 % patients had locoregional disease (stage I/II/III) at presentation.CEA levels were elevated in 36.9% of patients, while most common histology was signet ring cell histology which was present in 51.5% of patients. Of 76 patients with locoregional disease, 75% received neoadjuvant chemoradiotherapy, 7.9% received neoadjuvant chemotherapy alone while 3.9% received neoadjuvant radiotherapy alone. Of 76 patients with locoregional disease, 55 patients underwent surgery of which 53.9% underwent low anterior resection while 18.4% underwent abdomino-perineal resection. Pathologic CR rates were seen in 13.3%, while recurrences were seen in 55.4% of non-metastatic patients. Overall 5-year survival for the whole study group was 19.5%, while 1-year PFS and 3-year DFS for metastatic and non-metastatic disease were 5% and 43.8% respectively. On regression analysis elevated CEA levels and not achieving a pathologic CR (pCR) with neoadjuvant therapy had a trend towards worse overall survival (HR 2, 95% CI 1-4, p = 0.063), (HR 4.7, 95% CI 0.64-35.1, p = 0.125) respectively. Conclusions: Rectal cancers in Asia present at younger age and this younger population is associated with advanced stage, increased CEA at presentation, aggressive histology and poor survival. CEA raise and not achieving pCR were associated with trend towards worse survival.

scholarly journals Colorectal Cancer in Young Adult Population in Kashmir Valley: Tertiary Care Centre Experience

JMS SKIMS ◽  
2019 ◽  
Vol 22 (2) ◽  
Author(s):  
Peerzada Umar Farooq Baba ◽  
Ajaz Ahmad Malik ◽  
Yaqoob Hassan ◽  
Khurshid Alam Wani ◽  
Abdul Rashid Lone
Keyword(s):  
Colorectal Cancer ◽  
Young Adults ◽  
Adjuvant Therapy ◽  
Colorectal Carcinoma ◽  
Adult Population ◽  
Tertiary Care ◽  
Young Patients ◽  
Kashmir Valley ◽  
Female Ratio

Background: Colorectal cancer has been defined and discussed as a disease of middle or late life. However, no age-group is exempt, and adenocarcinoma of the colon has been reported in young age. Malignant disease is frequently found in young adults in our Kashmir valley. Objective (s): This aim was to study the clinic pathological features, diagnosis, management and outcome of colorectal cancer in young adults under the age of 40. Material and Methods: This combined Retrospective (January 2002 to May, 2004) Prospective (June 2004 to September 2006) Observational Study was conducted in the department of General and Minimal Access Surgery, SKIMS,. Total of 62 young colorectal carcinoma patients were studied. The case records of all the patients of colorectal cancer less than 40years of age admitted in the department of General Surgery were reviewed retrospectively. In the prospective study all the patients less than 40 years of age with colorectal carcinoma admitted in our department were registered. Following the confirmation of diagnosis, the patients were subjected to exploratory laparotomy. The nature of the surgical procedure depended upon the intra-operative findings. All the patients were subjected to postoperative chemotherapy and in selected cases to postoperative chemo-radiation. The patients were followed for a period of five years .The patients were thoroughly examined and investigated on follow up to rule out any recurrence or metastasis. Results: Most of our patients (83.9%) were admitted through outpatient department (OPD) and only 10 patients (16.1%) were admitted through emergency. In our study, the male: female ratio was 1.58: 1.The mean age in our study was 30.2 years. Bleeding per rectum was the most common (74.2%) presenting symptom followed by altered bowel habits (72.6%). Carcinoembryonic antigen (CEA) levels show significant decline after surgery/adjuvant therapy. Colonoscopy detected synchronous growths in 5.3% of patients. Rectum was the most common site of lesion (32.2%) while combined rectum and sigmoid colon (including recto sigmoid) accounted for 62.7% of lesions. Resection with intention of cure was performed in 68.3% of patients, palliative procedure in 26.7% and biopsy in 5% of patients. Postoperative complications were recorded and managed accordingly. Typical adenocarcinoma was seen in 80.6% of patients. None of our patients had Dukes stage A presentation. 13.6% of patients had local recurrence and 25.4% had metastasis on follow up.                                                 Conclusion: Colorectal cancers in young adults are quite common in Kashmir valley. Outcome of CRC in young patients is significantly related to the procedure - whether done with curative intention or for palliation. Henceforth, surgical treatment should be radical and optimized with adjuvant therapy where possible to achieve the best prognosis. The diagnosis of colorectal cancer should be done at the early and curable stage for better outcome.

scholarly journals Trends of oesophageal carcinoma and increasing number of young patients with oesophageal carcinoma in Southern Punjab, Pakistan

2021 ◽  
Vol 8 (11) ◽  
pp. 5184
Author(s):  
Afra Samad ◽  
Safia Sartaj ◽  
Rafia Sartaj ◽  
Namra Naeem
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Young Patients ◽  
Oesophageal Carcinoma ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Male Predominance ◽  
Frequent Type

Background: Oesophageal cancer (OC) is a cancer that develops in the gastrointestinal tract and is caused by a variety of circumstances. It has quite an uneven geographic distribution with male predominance and squamous cell carcinoma being most frequent type of oesophageal carcinoma in developing countries. As Pakistan lacks any proper cancer registry this study was needed to have an idea of the OC statistics in South Punjab region. Objective was to determine the prevalence of OC in the general population and in young people of South Punjab, PakistanMethods: Retrospective cross-sectional study. Two hundred and twenty-three patients who presented to Multitest lab from 2014 to 2018 were included in the study.Results: The 186 patients were positive for OC. Sixty patients were below 40 years of age. Male to female ratio was 1.24:1. Most frequent symptom was dysphagia and squamous cell carcinoma was histological subtype.Conclusions: In our study based on South Punjab region, oesophageal carcinoma has become a common condition and is more prevalent in males. It commonly involves upper oesophagus and squamous cell carcinoma is the most frequent type. It can also be concluded that it is in increasing in young population of South Punjab.

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