Predictive value of initial imaging and staging with long-term outcomes in young adults diagnosed with colorectal cancer.
Abdom Radiol (NY)
; 46(3): 909-918, 2021 03.
Article
em En
| MEDLINE
| ID: mdl-32936419
ABSTRACT
PURPOSE:
To evaluate how initial abdominopelvic CT findings and staging correlate with outcomes in a cohort of patients aged 18-40 years.METHODS:
We evaluated all young adult patients at a single tertiary center diagnosed with histopathologically confirmed CRC who also had CT of the abdomen and pelvis at the time of initial diagnosis. Demographics, symptoms, CT findings, staging, treatments, and outcomes at 1 year and 5 years were recorded.RESULTS:
Of 91 patients who met initial inclusion criteria, 81.8% had a mass present on CT, with an average size of 4.8 cm ± 2.9. A majority of patients were surgical stage III or IV (64.3%). Advanced AJCC stage was more common with rectal tumors and metastatic disease on initial CT (p < 0.0001). In a subgroup analysis, almost all patients initially staged 4A or higher had progression of disease. At the final follow-up visit, by RECIST 1.1 criteria, 58.8% had progressive disease, 35.3% complete response, and 3.9% stable disease. The overall 5-year survival rate in this subgroup was 40% with lower survival probability with increasing stage (p = 0.0001).CONCLUSION:
Most young adult patients presented with large tumors on imaging, increasing the likelihood of identification on CT. Tumors initially presenting in the rectum with enlarged lymph nodes and/or with distant metastases on CT were more often associated with advanced surgical stage and poorer prognosis. A majority of patients presented at an advanced stage, most commonly stage 4A, and had progression of disease at follow-up.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
/
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Abdom Radiol (NY)
Ano de publicação:
2021
Tipo de documento:
Article