TY - JOUR
T1 - Risk of metachronous neoplasia in early-onset colorectal cancer
T2 - meta-analysis
AU - Pellino, Gianluca
AU - Fuschillo, Giacomo
AU - González-Sarmiento, Rogelio
AU - Martí-Gallostra, Marc
AU - Selvaggi, Francesco
AU - Espín-Basany, Eloy
AU - Perea, Jose
N1 - Publisher Copyright:
© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.
PY - 2024/10/1
Y1 - 2024/10/1
N2 - Background: Metachronous colorectal cancer refers to patients developing a second colorectal neoplasia diagnosed at least 6 months after the initial cancer diagnosis, excluding recurrence. The aim of this systematic review is to assess the incidence of metachronous colorectal cancer in early-onset colorectal cancer (defined as age at diagnosis of less than 50 years) and to identify risk factors. Methods: This is a systematic review and meta-analysis performed following the PRISMA statement and registered on PROSPERO. The literature search was conducted in PubMed and Embase. Only studies involving patients with early-onset colorectal cancer (less than 50 years old) providing data on metachronous colorectal cancer were included in the analysis. The primary endpoint was the risk of metachronous colorectal cancer in patients with early-onset colorectal cancer. Secondary endpoints were association with Lynch syndrome, family history and microsatellite instability. Results: Sixteen studies met the inclusion criteria. The incidence of metachronous colorectal cancer was 2.6% (95% c.i. 2.287–3.007). The risk of developing metachronous colorectal cancer in early-onset colorectal cancer versus non-early-onset colorectal cancer patients demonstrated an OR of 0.93 (95% c.i. 0.760–1.141). The incidence of metachronous colorectal cancer in patients with Lynch syndrome was 18.43% (95% c.i. 15.396–21.780), and in patients with family history 10.52% (95% c.i. 5.555–17.659). The proportion of metachronous colorectal cancer tumours in the microsatellite instability population was 19.7% (95% c.i. 13.583–27.2422). Conclusion: The risk of metachronous colorectal cancer in patients with early-onset colorectal cancer is comparable to those with advanced age, but it is higher in patients with Lynch syndrome, family history and microsatellite instability. This meta-analysis demonstrates the need to personalize the management of patients with early-onset colorectal cancer according to their risk factors.
AB - Background: Metachronous colorectal cancer refers to patients developing a second colorectal neoplasia diagnosed at least 6 months after the initial cancer diagnosis, excluding recurrence. The aim of this systematic review is to assess the incidence of metachronous colorectal cancer in early-onset colorectal cancer (defined as age at diagnosis of less than 50 years) and to identify risk factors. Methods: This is a systematic review and meta-analysis performed following the PRISMA statement and registered on PROSPERO. The literature search was conducted in PubMed and Embase. Only studies involving patients with early-onset colorectal cancer (less than 50 years old) providing data on metachronous colorectal cancer were included in the analysis. The primary endpoint was the risk of metachronous colorectal cancer in patients with early-onset colorectal cancer. Secondary endpoints were association with Lynch syndrome, family history and microsatellite instability. Results: Sixteen studies met the inclusion criteria. The incidence of metachronous colorectal cancer was 2.6% (95% c.i. 2.287–3.007). The risk of developing metachronous colorectal cancer in early-onset colorectal cancer versus non-early-onset colorectal cancer patients demonstrated an OR of 0.93 (95% c.i. 0.760–1.141). The incidence of metachronous colorectal cancer in patients with Lynch syndrome was 18.43% (95% c.i. 15.396–21.780), and in patients with family history 10.52% (95% c.i. 5.555–17.659). The proportion of metachronous colorectal cancer tumours in the microsatellite instability population was 19.7% (95% c.i. 13.583–27.2422). Conclusion: The risk of metachronous colorectal cancer in patients with early-onset colorectal cancer is comparable to those with advanced age, but it is higher in patients with Lynch syndrome, family history and microsatellite instability. This meta-analysis demonstrates the need to personalize the management of patients with early-onset colorectal cancer according to their risk factors.
KW - Age
KW - Carcinomas
KW - Colon-cancer
KW - Colonoscopy surveillance
KW - Microsatellite instability
KW - Outcomes
KW - Predicts
KW - Resection
KW - Surgery
KW - Young-patients
UR - http://www.scopus.com/inward/record.url?scp=85203222366&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/5aca01b0-2622-3e8e-8213-f651b10ddd6a/
UR - https://portalrecerca.uab.cat/en/publications/fafd10e1-9a03-4e67-9fea-a132b7cb2e90
U2 - 10.1093/bjsopen/zrae092
DO - 10.1093/bjsopen/zrae092
M3 - Review article
C2 - 39230922
SN - 2474-9842
VL - 8
JO - BJS Open
JF - BJS Open
IS - 5
M1 - zrae092
ER -
