Rectal Cancer: Current Treatment has No Survival Benefit in Young Patients

Individuals under the age of fifty years who are diagnosed with rectal cancer were found to have no survival benefit from the current recommended treatments, reports a new study. The findings of the study are published online in a peer-reviewed journal of the American Cancer Society CANCER.// Current national guidelines--which recommend a combination of chemotherapy, radiation, and surgery for stages II and III rectal cancer--are predominantly based on data from patients older than fifty years of age. To examine how younger patients fare, a team led by Atif Iqbal, MD, of the University of Florida College of Medicine, in Gainesville, examined 2004-2014 information from the National Cancer Database. A total of 52,519 patients were analyzed.

The team found that patients younger than fifty years old who have been diagnosed with rectal cancer represent a unique group. These younger patients do not see a survival benefit from receiving the currently recommended treatment for stages II and III rectal cancer.

"Our findings support the notion that rectal cancer in young patients may be biologically different from older patients, with differing response to treatment, as has been previously shown in colon cancer," said Dr. Iqbal. "These findings may help stimulate future research trial proposals focused on the younger patient population." The study also reveals age-specific survival data for younger patients. "These data provide practicing physicians the ability to offer a prognosis personalized to the younger population, which can greatly improve discussions with younger patients."

In an accompanying editorial, Matthew Kalady, MD, of the Cleveland Clinic notes that the findings highlight the need to continually evaluate approaches to colorectal cancer prevention, screening, and treatment. "This manuscript should open the eyes of physicians treating rectal cancer patients and of those making treatment guideline recommendations and screening policies," he wrote. He noted that the study did not address other clinically important endpoints for rectal cancer patients such as local recurrence and disease-free survival. He added that studies are needed to evaluate how factors such as diet, physical activity and obesity, underlying genetics, and gut microbes may interact with rectal cancer biology.



Source-Eurekalert