The incidence of rectum cancer in young subjects is low, but the prognosis is poor. This cancer has unknown anatomic clinical features and its evolution. The aim of this study was to describe the anatomical characteristics and the prognostic factors of rectum cancer in young patients. In this retrospective study, 74 patients were enrolled. Data were collected on the clinical variables and the treatment of each patient. The survival of the patients was evaluated in both groups.
The National Surgical Adjuvant Breast and Bowel Project (NSABP) R-03 trial compared adjuvant chemotherapy to neoadjuvant chemotherapy in patients with locally advanced rectal cancer. Although the study did not meet its enrollment criteria and was prematurely closed, the results of the trial indicate that adjuvant chemotherapy has a favorable prognostic impact in localized RCA. The authors found that adjuvant chemotherapy has an additional prognostic role in localized T4 cancer.
The risk factors for rectum cancer are increased by personal and family history. Adenomatous polyps with tubulovillous dysplasia are risk factors, and such patients should be screened closely. Additionally, inflammation of the bowel has been associated with increased risk of cancer. Inflammation of the colon is more common in patients with Crohn’s disease and ulcerative colitis. The two conditions may be associated and increase the risk of rectal cancer.
Both types of rectum cancer are characterized by the presence of metastasis to other organs. Although rectum cancer patients had a higher risk of lung and liver metastasis than patients with colorectal cancer, there were no significant differences in the rate of bone and lung metastasis. However, it should be noted that colorectal cancer patients with metastasis to the lungs and brain have a higher overall risk of colon and rectum cancer metastasis.
A change in bowel habits is the most common symptom of colorectal cancer. A change in bowel habits is common and symptoms such as diarrhoea and constipation may appear. Some stools may contain blood or mucus. Having a tumour in the rectum is also associated with the sensation of having not emptied the bowels. The cancer can also cause other symptoms such as a feeling of general unwellness, being listless, and fatigued.
In general, survival rates for patients with rectum cancer were similar in both countries, although there were some differences in the risk factors and age of diagnosis. However, the differences in survival rates were much greater for patients with localised cancer (stage A) than for those with’stage C’ or’stage ‘D’. In addition, patients with stage ‘D’ cancer had a higher Duke’s D proportion, which increased from 24.8% in France to 28.3% in England.
The operativeness rate of patients was 69%, and forty of them underwent curative surgery. Twenty-five patients received chemotherapy postoperatively. Of these forty patients, 18 suffered recurrence. The recurrence rate was local-regional in twelve cases and metastatic in six cases. In addition, the three-year survival rate was 5%. These results demonstrate the importance of following up with regular visits to a hospital.
