Treatment of carcinomatosis using cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in adolescents and young adults.
BACKGROUND
Among colorectal carcinoma patients, approximately 150 patients/year are age 25 years old or younger according to Surveillance, Epidemiology, and End Results Program statistics. Because of lack of screening in their age group, they are at risk to have more advanced disease and have been largely unstudied.


OBJECTIVE
To determine outcome of colon cancer adolescent and young adult patients.


METHODS
Patients under the age of 26 were retrospectively reviewed from a single institution.


RESULTS
The 5-year overall survival rate from the time of the first surgery was .45 (95% confidence interval .17 to .70). The median overall survival for the cohort was 2.98 years. Patients aged 15 to 21 years had a poorer overall survival than patients aged 22 to 25 years (82% survival vs 100% at 2 years and zero vs 56% at 5 years). Five patients underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Three are alive at 82, 36, and 16 weeks after hyperthermic intraperitoneal chemotherapy.


CONCLUSIONS
Patients less than 21 years with nonsyndromic colorectal carcinoma may have a poorer outcome. Novel, more aggressive therapy may be necessary in these patients.
Department of Surgical Oncology, University of Texas Houston Health Sciences, MD Anderson Cancer Center, Houston, TX, USA.
James
J
Oyeniyi
Department of Biostatistics, University of Texas Houston Health Sciences, MD Anderson Cancer Center, Houston, TX, USA.
Jumin
J
Wu
Department of Biostatistics, University of Texas Houston Health Sciences, MD Anderson Cancer Center, Houston, TX, USA.
Diane
D
Liu
Department of Medical Oncology, University of Texas Houston Health Sciences, MD Anderson Cancer Center, Houston, TX, USA.
James C
JC
Yao
Department of Surgical Oncology, University of Texas Houston Health Sciences, MD Anderson Cancer Center, Houston, TX, USA.
Holly
H
Green
Department of Pediatrics, Cook Children's Medical Center, Fort Worth, TX, USA.
Karen
K
Albritton
Division of Pediatrics, University of Texas Houston Health Sciences, MD Anderson Cancer Center, Houston, TX, USA.
Winston
W
Huh
Department of Surgical Oncology, University of Texas Houston Health Sciences, MD Anderson Cancer Center, Houston, TX, USA. Electronic address: ahjordan@mdanderson.org.
Andrea
A
Hayes-Jordan
D000293:Adolescent; D000328:Adult; D002277:Carcinoma / Q000628:therapy*; D010478:Chemotherapy, Cancer, Regional Perfusion; D015179:Colorectal Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D006801:Humans; D006979:Hyperthermia, Induced; D012189:Retrospective Studies; D055815:Young Adult
Adolescent and young adult; Colon carcinoma; HIPEC; Metastasis; Peritoneal