Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review.

The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes

Minimally invasive technologies in complex treatment of patients with acute fluid clusters in sterile pancreatonecrosis

OBJECTIVE. The study investigated the efficacy of minimally invasive interventions in patients with sterile form of pancreatonecrosis. MATERIAL AND METHODS. There were 202 patients with sterile form of pancreatonecrosis during 5 years. Local complications such as acute fluid clusters were revealed in 136 (67,3 %) and dense infiltrates were noted in 66 (32,7 %) patients. Minimally invasive surgeries were performed on 132 (65,3 %) patients. RESULTS. Pathological process was successfully treated in 97,2 % patients by using given methods and convertion to open surgery was performed in 2,8 % patients. CONCLUSIONS. The application of minimally invasive methods was final in 97,2 % patients with sterile form of pancreatonecrosis without lethal outcomes

LONG TERM RESULTS OF PERCUTANEOUS CORONARY INTERVENTIONS COMPARING WITH CONSERVATIVE MANAGEMENT IN TREATMENT OF STABLE ISCHEMIC HEART DISEASE PATIENTS UNDER REAL CIRCUMSTANCES

Aim. To evaluate long term results of percutaneous coronary interventions (PCI) in stable ischemic heart disease patients (IHD) under real clinical circumstances.Material and methods. The PCI group consisted of 150 patients with stable IHD after PCI, randomly selected from the Registry of Coronary Angiography. Comparison group consisted of randomly selected from the Registry 150 patients with stable IHD receiving only drug therapy (DT).Results. In long term perion it was found that total mortality (4,0% vs. 11,3%, p=0,017) and cardiovascular mortality (3,3% vs. 10,7%, p=0,013) were lower in PCI group. After PCI there was rarer coronary bypass operation need (2,0% vs. 10,0%, p=0,004). By the prevalence of myocardial infarction in compared groups there were no statistically significant differences (6,7% vs. 5,3%, p=0,627). Kaplan-Meier curve analysis showed that positive effect of PCI was fulfilled in 15 months and progressively increased until the end of follow-up. In stepped regression of Cox proportional risks it was revealed that in long term period PCI performing associated with the increase of survival rate 2,8 times (RR=2,81, 95% CI 1,03-7,69, p=0,044). Long term survival showed independent relation with the grade of coronary lesion. In PCI group, as in DT group, there were no positive dynamics of angina functional classes. In MT group during the follow-up functional class of heart failure became harder than in PCI group, and in PCI groupthere were no significant dynamics of heart failure functional class.Conclusion. Real clinical practice proved the effectiveness of PCI with DT in treatment of stable IHD. In long term results evaluation, PCI for stable IHD associated with the increase of survival 2,8 times comparing with the group with only DT. Positive PCI effect realized after 15 months and progressively increased to the end of follow-up

Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review.

ImportanceThe incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer.ObservationsWithin the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts.Conclusions and relevanceThe clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes

Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review.

ImportanceThe incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer.ObservationsWithin the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts.Conclusions and relevanceThe clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes