Background: The rising incidence of colorectal cancer (CRC) among young patients is alarming. We aim to characterize the clinico-pathological features and outcomes of patients with early-onset CRC (EOCRC), as well as the impacts of COVID-19 pandemic. Methods: We included all patients with pathologically confirmed diagnoses of CRC at Hospital Universitario La Paz from October 2016 to December 2021. The EOCRC cut-off age was 50 years old. Results: A total of 1475 patients diagnosed with CRC were included, eighty (5.4%) of whom had EOCRC. Significant differences were found between EOCRC and later-onset patients regarding T, N stage and metastatic presentation at diagnosis; perineural invasion; tumor budding; high-grade tumors; and signet ring cell histology, with all issues having higher prevalence in the early-onset group. More EOCRC patients had the RAS/ BRAF wild type. Chemotherapy was administered more frequently to patients with EOCRC. In the metastatic setting, the EOCRC group presented a significantly longer median OS. Regarding the COVID-19 pandemic, more patients with COVID-19 were diagnosed with metastatic disease (61%) in the year after the lockdown (14 March 2020) than in the pre-pandemic EOCRC group (29%). Conclusions: EOCRC is diagnosed at a more advanced stage and with worse survival features in localized patients. More patients with EOCRC were diagnosed with metastatic disease in the year after the COVID-19 pandemic lockdown. The long-term consequences of COVID-19 are yet to be determined.
背景：年轻患者结直肠癌（CRC）发病率上升令人担忧。本研究旨在分析早发性结直肠癌（EOCRC）患者的临床病理特征及预后，并探讨COVID-19大流行的影响。方法：纳入2016年10月至2021年12月在拉巴斯大学医院经病理确诊的所有CRC患者，EOCRC年龄界定为≤50岁。结果：共纳入1475例CRC患者，其中80例（5.4%）为EOCRC。EOCRC与晚发性患者在诊断时的T分期、N分期及转移表现、神经侵犯、肿瘤出芽、高级别肿瘤、印戒细胞组织学类型等方面存在显著差异，且上述特征在早发组中发生率更高。EOCRC患者中RAS/BRAF野生型比例更高，接受化疗更频繁。在转移性患者中，EOCRC组中位总生存期显著延长。关于COVID-19大流行的影响，在封锁措施实施后一年（2020年3月14日起），合并COVID-19感染的EOCRC患者中转移性病变诊断比例（61%）显著高于大流行前EOCRC组（29%）。结论：EOCRC确诊时分期更晚，局部进展期患者生存特征更差。COVID-19封锁措施实施后一年内，更多EOCRC患者被诊断为转移性疾病。COVID-19对结直肠癌诊疗的长期影响仍需进一步研究。
肿瘤(癌症)患者之家