PURPOSE

Colorectal cancer (CRC) is rarely found in children and adolescents. The purpose of this study was to retrospectively conduct a population-based cohort of pediatric patients with CRC.

METHODS

All pediatric patients with CRC diagnosed between 1975 and 2018 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. The demographics and clinical variables of the patients were summarized, and treatment outcomes and prognostic factors were examined. The study was presented in accordance with the STROBE reporting checklist.

RESULTS

A total of 284 CRC patients were identified. At 3- and 5-year follow-up, the overall survival rates were 63.1% and 52.6%, respectively. Patients with local disease had a significantly improved overall survival (OS) than patients with distant disease. At 3- and 5-year follow-up, the overall survival rates of adenocarcinoma (nos) and adenocarcinoma (polyp) were similar and significantly better than those of patients with mucinous adenocarcinoma and signet ring cell carcinoma (P < 0.001). In terms of treatment, patients who underwent surgery outlived non-surgery patients (3-year OS, 70.4% versus 26.6%, P < 0.001). Multivariate analysis revealed that SEER stage and histologic type were important independent predictors of outcomes.

CONCLUSIONS

Children and adolescents with CRC are likely to be in an advanced stage, have a worse histologic subtype, and have a poorly differentiated grade. Although surgical resection considerably increases survival for the majority of patients, pediatric patients with CRC have a poor prognosis. Considerable efforts are required to improve their survival outcomes.