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

Surgical treatment of varicocele [Il trattamento chirurgico del varicocele.]

The correlation between varicocele and infertility has been established for many years. Authors expose their twelve years experience on surgical treatment of varicocele. 213 cases have been treated: 105 had infertility associated to varicocele and a microsurgical treatment has been performed. A high legature of spermatic vein has been applied to 108 patients with normal spermiogram (the last 6 by laparoscopic technique). In the case in which there is alteration of the spermiogram the microsurgical treatment seems more efficient for the sperm quality because it is more valuable in eliminating the venous stasis, and the operation Belgrano 1 seems to be the best compared to the others. Correlating the treatment efficiency to the simplicity of the application and to the treatment expense and reduced morbility we think it is advisable to treat the spermatic vein with laparoscopic ligature in patients with normal fertility indexes, even on the basis of our recent experience. Physiopathology, economic reasons and efficacy have been demonstrated

Surgical treatment of varicocele [Il trattamento chirurgico del varicocele.]

The correlation between varicocele and infertility has been established for many years. Authors expose their twelve years experience on surgical treatment of varicocele. 213 cases have been treated: 105 had infertility associated to varicocele and a microsurgical treatment has been performed. A high legature of spermatic vein has been applied to 108 patients with normal spermiogram (the last 6 by laparoscopic technique). In the case in which there is alteration of the spermiogram the microsurgical treatment seems more efficient for the sperm quality because it is more valuable in eliminating the venous stasis, and the operation Belgrano 1 seems to be the best compared to the others. Correlating the treatment efficiency to the simplicity of the application and to the treatment expense and reduced morbility we think it is advisable to treat the spermatic vein with laparoscopic ligature in patients with normal fertility indexes, even on the basis of our recent experience. Physiopathology, economic reasons and efficacy have been demonstrated

Frequency and pattern of endoscopic recurrence in Crohn's disease patients with ileocolonic resection using a laparoscopic versus laparotomic approach: A prospective longitudinal study

[No abstract available