Risk of metachronous neoplasia in early-onset colorectal cancer : meta-analysis
Pellino, Gianluca (Hospital Universitari Vall d'Hebron)
Fuschillo, Giacomo (Università degli Studi della Campania 'Luigi Vanvitelli' (Naples, Itàlia))
González-Sarmiento, Rogelio (Instituto de Investigación Biomédica de Salamanca)
Martí-Gallostra, Marc (Hospital Universitari Vall d'Hebron)
Selvaggi, Francesco (Università degli Studi della Campania 'Luigi Vanvitelli' (Naples, Itàlia))
Espin-Basany, Eloy (Hospital Universitari Vall d'Hebron)
Perea García, José (Instituto de Investigación Biomédica de Salamanca)
Universitat Autònoma de Barcelona

Data:	2024
Resum:	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. 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. 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). 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. The risk of metachronous colorectal cancers in patients with early-onset colorectal cancer is comparable to those with advanced age, but they can occur later and be associated with family history and Lynch syndrome, advocating the need to identify the ideal follow-up pathways in this patient population.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	BJS Open, Vol. 8 (september 2024) , ISSN 2474-9842

DOI: 10.1093/bjsopen/zrae092
PMID: 39230922

8 p, 316.3 KB

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