Colorectal cancer in young patients

ABSTRACT

Twenty three patients with colorectal cancer under the age of 40, were presented in the study over a period of 4 years. Fourteen patients were males while nine patients were females. Their age ranged from 12-39 years. Four cases were presented with acute emergency conditions, while 19 patients were discovered during routine work up for symptomatically ill patients. The most common presenting symptoms were abdominal pain, change in bowel habit, bleeding per rectum and weight loss. Carcinomata were found most commonly in rectosigmoid region [Rectum 8 cases sigmoid 7 cases] whereas the remaining eight cases were distributed in the proximal colon. Only one case had multifocal lesions. On pathologic staging Dukes' B and C stages represented the most common pathologic stages being 7 and 11 cases, respectively. While only 2 cases had Dukes' A lesion and 3 cases had Dukes' D lesion. Various surgical procedures have been used according to the site of the tumour. Resection was aiming at cure in 18 cases. All the tumours were adeno carcinoma. Mucin producing tumours were documented in 3 cases. Follow up continued for 26-61 months postoperatively. Only 6 patients developed recurrences in the first-two postoperative years. The overall survival after 2 years was 86.9% and the rate of disease free follow up for two years was 69.5%. The duration of symptoms before presentation did not seem to carry a significant relation with the Dukes', stage or with the survival rate