{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:40:11Z","timestamp":1777876811420,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Med Oncol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The incidence of early-onset colorectal cancer (EO-CRC), defined as a diagnosis before 50\u2009years of age, is increasing worldwide. However, its clinical characteristics and outcomes compared to average-onset colorectal cancer (AO-CRC) remain under debate, especially in the setting of locally advanced rectal cancer (LARC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to compare clinical characteristics, treatment responses, and survival outcomes between patients with early-onset and average-onset locally advanced rectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A multicenter retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively analysed 305 patients with stage II\u2013III rectal cancer treated between 2012 and 2022 across three Italian oncology centrers. Patients were categorised as EO-RC (\u2a7d50\u2009years) or AO-RC (&gt;50\u2009years). All patients underwent neoadjuvant chemoradiotherapy followed by total mesorectal excision. Pathological and radiological responses were evaluated, and survival outcomes were assessed through Kaplan-Meier methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Early-onset patients accounted for 10.5% of the cohort. Clinical and pathological characteristics were broadly similar between groups, although EO-RC patients had a higher prevalence of proficient mismatch repair status. Radiological and pathological response rates were comparable. After a median follow-up of 120\u2009months, the 10-year overall survival (OS) was 73.3% in EO-RC and 91.9% in AO-RC (HR 7.60, 95% CI 2.22\u201326.06;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0012). Disease-free survival (DFS) at 10\u2009years was 57.1% in EO-RC and 70.9% in AO-RC (HR 1.80, 95% CI 0.86\u20133.78;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.1177).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Early-onset rectal cancer patients exhibit similar response rates and DFS compared to older patients, but appear to have worse OS. Further studies are needed to explore biological factors and post-recurrence treatment strategies that may influence these outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17588359251379744","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T10:54:30Z","timestamp":1771844070000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics and outcomes in patients with early-onset locally advanced rectal cancer"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0262-9270","authenticated-orcid":false,"given":"Andrea","family":"Pretta","sequence":"first","affiliation":[{"name":"Medical Oncology Unit, University Hospital and University of Cagliari, SS554 km 4,500 bivio per Sestu, Monserrato, Cagliari 09042, 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