Volume 9 , Issue 1 , March 2021 , Pages: 8 - 13
Colorectal Carcinoma in Children and Adolescents in Low Middle Income Countries: Single Center Experience
Wael Zekri, Department of Pediatric Oncology, Children Cancer Hospital Egypt, Cairo, Egypt; Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
Soha Ahmed, Department of Clinical Oncology, Aswan University, Aswan, Egypt
Ahmed Elhemaly, Department of Pediatric Oncology, Children Cancer Hospital Egypt, Cairo, Egypt; Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
Gehad Ahmed, Department of Surgery, Helwan University, Cairo, Egypt; Department of Surgery, Children Cancer Hospital Egypt, Cairo, Egypt
Eman Zaki, Department of Radio–diagnosis, Children Cancer Hospital Egypt, Cairo, Egypt; Department of Radio-diagnosis, National Cancer Institute, Cairo University, Cairo, Egypt
Naglaa Elkinaee, Department of Pathology, National Cancer Institute, Cairo University, Cairo, Egypt; Department of Pathology, Children Cancer Hospital Egypt, Cairo, Egypt
Amr Elnashar, Department of Clinical Research, Children Cancer Hospital Egypt, Cairo, Egypt
Marwan Adly, Department of Clinical Research, Children Cancer Hospital Egypt, Cairo, Egypt
Alaa Younes, Department of Surgery, Helwan University, Cairo, Egypt; Department of Surgery, Children Cancer Hospital Egypt, Cairo, Egypt
Asmaa Hamoda, Department of Pediatric Oncology, Children Cancer Hospital Egypt, Cairo, Egypt; Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
Received: Dec. 18, 2020;       Accepted: Jan. 8, 2021;       Published: Jan. 22, 2021
DOI: 10.11648/j.crj.20210901.12        View        Downloads  
Abstract
Colorectal carcinoma (CRC) is rare in children with extremely poor prognosis. Proper management is obscure because of deficient data. The aim of the current study is to assess the clinical characteristics and to determine the different prognostic factors leading to dismal outcome. It is a retrospective study included all CRC patients, below 18 years, treated in Children’s Cancer Hospital of Egypt (CCHE) between 2007 and 2016. Demographic data, clinical characteristics, diagnostics, histological subtypes, disease stage, treatment methods, and survival outcome were collected. The result showed that, 15 patients below 18 years. All had unfavorable histopathology (mucinous adenocarcinoma) and 10 cases had metastatic disease. Initial surgical resection was done in 8/15 cases, all patients received neo adjuvant/adjuvant chemotherapy. Four patients had rectal adenocarcinoma and were treated with chemo-radiotherapy while 11 had colonic adenocarcinoma. Ten patients had progression or relapse, while 12 died at the end of follow up period; 3-years Overall Survival (OS) and Event Free Survival (EFS) were 17.8% and 16.5% respectively, the only three surviving patients were of lower stage disease. In Conclusions, Clinical presentation of CRC in pediatrics is similar to adults but delayed diagnosis and advanced stages contribute to poor outcome which is due to the absence of familiarity to CRC. The high frequency of mucinous adenocarcinoma may explain the poor outcome. Surgery remains the mainstay of treatment as in adults. Preoperative radiotherapy for rectal adenocarcinoma, offers better prognosis. Chemotherapy plays a role in the metastatic disease and can downstage the primary tumor for better local control.
Keywords
Colon, Rectal, Adenocarcinoma, Childhood, Adulthood
To cite this article
Wael Zekri, Soha Ahmed, Ahmed Elhemaly, Gehad Ahmed, Eman Zaki, Naglaa Elkinaee, Amr Elnashar, Marwan Adly, Alaa Younes, Asmaa Hamoda, Colorectal Carcinoma in Children and Adolescents in Low Middle Income Countries: Single Center Experience, Cancer Research Journal. Vol. 9, No. 1, 2021, pp. 8-13. doi: 10.11648/j.crj.20210901.12
Copyright
Copyright © 2021 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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