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World J Gastroenterol. Dec 14, 2014; 20(46): 17288-17296
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17288
Early-onset colorectal cancer: A separate subset of colorectal cancer
Irene Osorio Silla, Daniel Rueda, Yolanda Rodríguez, Juan Luis García, Felipe de la Cruz Vigo, José Perea
Irene Osorio Silla, Felipe de la Cruz Vigo, José Perea, Department of Surgery, 12 de Octubre University Hospital, Madrid 28041, Spain
Daniel Rueda, Molecular Biology Laboratory, 12 de Octubre University Hospital, Madrid 28041, Spain
Yolanda Rodríguez, Department of Pathology, 12 de Octubre University Hospital, Madrid 28041, Spain
Juan Luis García, Centre for Cancer Research, Medical University of Salamanca, Salamanca 37008, Spain
Author contributions: Rueda D, Rodríguez Y and García JL acquired and analyzed data; Cruz Vigo F and Perea J revised the article; Osorio Silla I designed and wrote the article.
Supported by Project PI10/0683 from the Spanish Ministry of Health and Consumer Affairs
Correspondence to: José Perea, MD, PhD, Department of Surgery, 12 de Octubre University Hospital, Avd. de Córdoba S/N, Madrid 28041, Spain. josepereag@hotmail.com
Telephone: +34-6-69332053 Fax: +34-6-69332053
Received: May 25, 2014
Revised: July 27, 2014
Accepted: November 7, 2014
Published online: December 14, 2014
Processing time: 207 Days and 10.9 Hours
Abstract

Colorectal cancer (CRC) has a great impact on the world population. With increasing frequency, CRC is described according to the presenting phenotype, based on its molecular characteristics. Classification of CRC tumors according to their genetic and/or epigenetic alterations is not only important for establishing the molecular bases of the disease, but also for predicting patient outcomes and developing more individualized treatments. Early-onset CRC is a heterogeneous disease, with a strong familial component, although the disease is sporadic in an important proportion of cases. Different molecular alterations appear to contribute to the apparent heterogeneity of the early-onset population and subgroups can be distinguished with distinct histopathologic and familial characteristics. Moreover, compared with late-onset CRC, there are characteristics that suggest that early-onset CRC may have a different molecular basis. The purpose of this review was to analyze the current state of knowledge about early-onset CRC with respect to clinicopathologic, familial and molecular features. Together, these features make it increasingly clear that this subset of CRC may be a separate disease, although it has much in common with late-onset CRC.

Keywords: Chromosomal instability; CpG island methylator phenotype; Early-onset colorectal cancer; Lynch syndrome; Microsatellite instability

Core tip: Early-onset colorectal cancer is a heterogeneous disease with various molecular alterations, in which different subgroups with different histopathologic and familial characteristics can be distinguished. Classification of colorectal cancer tumors according to their genetic alterations is important for establishing the molecular bases of the disease, as well as for predicting patient outcomes and developing more individualized treatments.