Outcomes of Rectal Cancer in Young Patients: A Comprehensive Analysis from a Tertiary Cancer Centre in North-East India
摘要
Rectal cancer in young patients [YRC] is emerging as a significant health concern, especially in low-resource settings like India, where molecular profiling and targeted therapies are not widely accessible. This study aims to evaluate the baseline demographics, clinicopathological characteristics, treatment patterns, survival outcomes, failure patterns, and treatment compliance among rectal cancer patients aged ≤ 40 years. A retrospective analysis was conducted using electronic medical records of YRC patients registered at a tertiary cancer center in Northeast India from January 2020 to December 2022. Of the 214 patients aged ≤ 40 years, 118 with complete clinical data were included. Treatment compliance was assessed, and patients lost to follow-up were contacted telephonically. Those unreachable [n = 4] were excluded from survival analysis. YRC accounted for 26.9% of all rectal cancer cases. Most patients were aged 31–40 years [55.9%], with a male-to-female ratio of 1.8:1. Upfront metastases were seen in 27%, and 31% had poor histological subtypes [signet-ring, mucinous, papillary]. Curative intent therapy was initiated in 70%, but only 44% completed treatment. Non-compliance [39%] was primarily due to disease progression during neoadjuvant therapy. For those completing treatment, median PFS was 46.6 months and median OS was 53.6 months. Palliative therapy yielded a median OS of 11.6 months. The incidence of YRC in our region is notably higher than global estimates. High rates of non-compliance and poor histology underscore the urgent need for resource-adapted, age-specific treatment guidelines and prospective studies focused on this younger population.