Does radiotherapy prior to surgery improve long term prognosis in pediatric colorectal cancer in lower- and upper-middle income countries with limited resources? Our experience and literature review

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Authors

Carrim, Yacoob Omar
Gaxa, Luvo
Van der Schyff, Fransica
Bida, Nndweleni Meshack
Omar, Fareed E.
Lockhat, Zarina I.

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Elsevier

Abstract

Colorectal carcinoma in children and adolescents is extremely rare, with an annual incidence <0.3 cases per million, most frequently reported in the second decade of life. It accounts for severe morbidity and poor prognosis owing to the low index of suspicion, delayed diagnosis, advanced stage at presentation and the aggressive tumor nature. Patients present with abdominal pain, vomiting, constipation, abdominal distension, rectal tenesmus, iron-deficiency anemia, change in bowel habit and weight loss. Rectal bleeding is an uncommon presentation in children. Bowel obstruction presents frequently in children compared to adults. In 90% of pediatric cases, colorectal carcinoma occurs sporadically. In 10%, predisposing conditions and syndromes are identified. We present a case study of a 12-year-old female with advanced colorectal cancer without a predisposing disease or syndrome, who received radiochemotherapy ten weeks prior to radical abdominopelvic surgery, followed by radio-chemotherapy postoperatively, with a positive outcome.

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Keywords

Pediatric colorectal carcinoma, Neoadjuvant, Mucinous, Fluorodeoxyglucose positron emission tomography (FDG PET), Tomography (FDG PET) negative, Carcinoembryonic antigen (CEA)

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Citation

Carrim, Y.O., Gaxa, L., Van der Schyff, F. et al. 2017, 'Does radiotherapy prior to surgery improve long term prognosis in pediatric colorectal cancer in lower- and upper-middle income countries with limited resources? Our experience and literature review', Journal of the Egyptian National Cancer Institute, vol. 29, pp. 201-206.