Prognostic Differences Between Early-Onset and Late-Onset Colorectal Cancer
<i>Background and Objectives</i>: Early-onset colorectal cancer (EO-CRC) has become a significant public health concern due to its alarming rise in incidence and the poor prognosis associated with this disease. The aim of our study was to identify epidemiological, clinical, and paraclini...
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2025-02-01
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| author | Vlad Alexandru Ionescu Gina Gheorghe Ioana-Alexandra Baban Alexandru Barbu Teodor Florin Georgescu Loredana-Crista Tiuca Ninel Antonie Iacobus Camelia Cristina Diaconu |
| author_facet | Vlad Alexandru Ionescu Gina Gheorghe Ioana-Alexandra Baban Alexandru Barbu Teodor Florin Georgescu Loredana-Crista Tiuca Ninel Antonie Iacobus Camelia Cristina Diaconu |
| author_sort | Vlad Alexandru Ionescu |
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| description | <i>Background and Objectives</i>: Early-onset colorectal cancer (EO-CRC) has become a significant public health concern due to its alarming rise in incidence and the poor prognosis associated with this disease. The aim of our study was to identify epidemiological, clinical, and paraclinical characteristics that could explain the more aggressive evolution of EO-CRC compared to late-onset colorectal cancer (LO-CRC). <i>Materials and Methods</i>: We conducted a retrospective study over a two-year period, including 204 patients diagnosed with colorectal cancer (CRC). The patients were divided into two subgroups: those with EO-CRC and those with LO-CRC. Statistical analysis was performed using IBM SPSS Statistics, Version 29.0. <i>Results</i>: EO-CRC was identified in 11.3% of the patients included in the study. Compared to LO-CRC patients, EO-CRC patients exhibited a tendency for more distal tumor localization and a stenotic endoscopic appearance (43.5% vs. 29.3%). Regarding histopathological diagnosis, EO-CRC patients demonstrated a higher proportion of the mucinous histologic subtype (34.8% vs. 14.4%) and a significantly greater percentage of poorly differentiated tumors (39.1% vs. 14.5%; <i>p</i> = 0.010). Immunohistochemical results, available for a limited number of patients, revealed higher CDX2 positivity in LO-CRC patients (<i>p</i> = 0.012) and higher HER2 positivity in EO-CRC patients (<i>p</i> = 0.002). Smoking (<i>p</i> = 0.006) and hypertension (<i>p</i> = 0.002) were more prevalent in EO-CRC patients than in LO-CRC patients. <i>Conclusions</i>: Patients with EO-CRC exhibit distinct histopathological and molecular characteristics compared to those with LO-CRC, which may contribute to their poorer prognoses. The higher prevalence of the mucinous histological subtype, poor tumor differentiation, increased HER2 expression, and reduced CDX2 expression suggest potential molecular pathways driving the aggressive nature of EO-CRC. These findings highlight the need for tailored screening strategies and personalized therapeutic approaches in younger CRC patients. Future studies should further investigate the underlying mechanisms and potential biomarkers that could guide early diagnoses and targeted treatments. |
| format | Article |
| id | doaj-art-e72839e2dc3d4df79edd96c5c997882c |
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| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
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| spelling | doaj-art-e72839e2dc3d4df79edd96c5c997882c2025-08-20T02:11:14ZengMDPI AGMedicina1010-660X1648-91442025-02-0161339010.3390/medicina61030390Prognostic Differences Between Early-Onset and Late-Onset Colorectal CancerVlad Alexandru Ionescu0Gina Gheorghe1Ioana-Alexandra Baban2Alexandru Barbu3Teodor Florin Georgescu4Loredana-Crista Tiuca5Ninel Antonie Iacobus6Camelia Cristina Diaconu7Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, RomaniaFaculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, RomaniaGastroenterology Department, Central Military Emergency University Hospital, 010825 Bucharest, RomaniaGastroenterology Department, Central Military Emergency University Hospital, 010825 Bucharest, RomaniaFaculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, RomaniaFaculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, RomaniaFaculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, RomaniaFaculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania<i>Background and Objectives</i>: Early-onset colorectal cancer (EO-CRC) has become a significant public health concern due to its alarming rise in incidence and the poor prognosis associated with this disease. The aim of our study was to identify epidemiological, clinical, and paraclinical characteristics that could explain the more aggressive evolution of EO-CRC compared to late-onset colorectal cancer (LO-CRC). <i>Materials and Methods</i>: We conducted a retrospective study over a two-year period, including 204 patients diagnosed with colorectal cancer (CRC). The patients were divided into two subgroups: those with EO-CRC and those with LO-CRC. Statistical analysis was performed using IBM SPSS Statistics, Version 29.0. <i>Results</i>: EO-CRC was identified in 11.3% of the patients included in the study. Compared to LO-CRC patients, EO-CRC patients exhibited a tendency for more distal tumor localization and a stenotic endoscopic appearance (43.5% vs. 29.3%). Regarding histopathological diagnosis, EO-CRC patients demonstrated a higher proportion of the mucinous histologic subtype (34.8% vs. 14.4%) and a significantly greater percentage of poorly differentiated tumors (39.1% vs. 14.5%; <i>p</i> = 0.010). Immunohistochemical results, available for a limited number of patients, revealed higher CDX2 positivity in LO-CRC patients (<i>p</i> = 0.012) and higher HER2 positivity in EO-CRC patients (<i>p</i> = 0.002). Smoking (<i>p</i> = 0.006) and hypertension (<i>p</i> = 0.002) were more prevalent in EO-CRC patients than in LO-CRC patients. <i>Conclusions</i>: Patients with EO-CRC exhibit distinct histopathological and molecular characteristics compared to those with LO-CRC, which may contribute to their poorer prognoses. The higher prevalence of the mucinous histological subtype, poor tumor differentiation, increased HER2 expression, and reduced CDX2 expression suggest potential molecular pathways driving the aggressive nature of EO-CRC. These findings highlight the need for tailored screening strategies and personalized therapeutic approaches in younger CRC patients. Future studies should further investigate the underlying mechanisms and potential biomarkers that could guide early diagnoses and targeted treatments.https://www.mdpi.com/1648-9144/61/3/390early-onset colorectal cancerlate-onset colorectal cancerprognosisendoscopic diagnosishistopathological diagnosisprognosis |
| spellingShingle | Vlad Alexandru Ionescu Gina Gheorghe Ioana-Alexandra Baban Alexandru Barbu Teodor Florin Georgescu Loredana-Crista Tiuca Ninel Antonie Iacobus Camelia Cristina Diaconu Prognostic Differences Between Early-Onset and Late-Onset Colorectal Cancer Medicina early-onset colorectal cancer late-onset colorectal cancer prognosis endoscopic diagnosis histopathological diagnosis prognosis |
| title | Prognostic Differences Between Early-Onset and Late-Onset Colorectal Cancer |
| title_full | Prognostic Differences Between Early-Onset and Late-Onset Colorectal Cancer |
| title_fullStr | Prognostic Differences Between Early-Onset and Late-Onset Colorectal Cancer |
| title_full_unstemmed | Prognostic Differences Between Early-Onset and Late-Onset Colorectal Cancer |
| title_short | Prognostic Differences Between Early-Onset and Late-Onset Colorectal Cancer |
| title_sort | prognostic differences between early onset and late onset colorectal cancer |
| topic | early-onset colorectal cancer late-onset colorectal cancer prognosis endoscopic diagnosis histopathological diagnosis prognosis |
| url | https://www.mdpi.com/1648-9144/61/3/390 |
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