{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:55:08Z","timestamp":1781495708760,"version":"3.54.1"},"reference-count":30,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: The incidence of early-onset colorectal cancer (EOCRC) has increased worldwide and now represents approximately 10% of colorectal cancers in high-income countries. EOCRC is frequently associated with advanced pathological features, although its clinical behavior and optimal management remain incompletely defined. Methods: We performed a retrospective single-center study including 88 consecutive patients aged \u226450 years who underwent curative-intent colorectal cancer resection between January 2019 and December 2023 at a tertiary referral center. Perioperative outcomes, pathological characteristics, and recurrence patterns were analyzed. Results: The median age was 44 years, and 67% of tumors were located in the colon. Pathological nodal involvement (pN+) was observed in 47.7% of patients, with a high prevalence of adverse features including perineural invasion (62.5%), tumor budding (17.0%), and tumor deposits (15.9%). Minimally invasive surgery was performed in 79% of patients and was associated with shorter hospital stay without increased postoperative morbidity (19.3%). During a median follow-up of 31.3 months [IQR 21.6\u201344.6], recurrence occurred in 40 patients (45.5%) and was predominantly distant (75.0%). Among patients with recurrence, 21 (52.5%) underwent surgical reintervention, most commonly hepatic and pulmonary resections. Rectal cancer was associated with higher rates of stoma formation and major postoperative complications compared to colon cancer. Conclusions: EOCRC is characterized by a high prevalence of adverse pathological features and a substantial rate of distant recurrence. However, a relevant proportion of recurrences remains amenable to surgical treatment in selected patients. Management in a specialized tertiary center allows achievement of high-quality surgical outcomes and supports an aggressive multidisciplinary approach.<\/jats:p>","DOI":"10.3390\/cancers18121934","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:01:27Z","timestamp":1781492487000},"page":"1934","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early-Onset Colorectal Cancer: Clinicopathological Features and Surgical Outcomes in Patients Treated with Curative Intent at a Tertiary Center"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4127-3585","authenticated-orcid":false,"given":"Clemente Junior","family":"Nappi","sequence":"first","affiliation":[{"name":"Colorectal Surgery, Department of General and Digestive Surgery, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4972-5315","authenticated-orcid":false,"given":"Arturo","family":"Cirera de Tudela","sequence":"additional","affiliation":[{"name":"Colorectal Surgery, Department of General and Digestive Surgery, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0783-6359","authenticated-orcid":false,"given":"Marc","family":"Mart\u00ed-Gallostra","sequence":"additional","affiliation":[{"name":"Colorectal Surgery, Department of General and Digestive Surgery, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"},{"name":"Department of Surgery, Universitat Aut\u00f2noma de Barcelona (UAB), 08193 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5642-1694","authenticated-orcid":false,"given":"Miquel","family":"Kraft Carre","sequence":"additional","affiliation":[{"name":"Colorectal Surgery, Department of General and Digestive Surgery, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"},{"name":"Department of Surgery, Universitat Aut\u00f2noma de Barcelona (UAB), 08193 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5522-8844","authenticated-orcid":false,"given":"Jos\u00e9","family":"Perea","sequence":"additional","affiliation":[{"name":"Surgery Department, Vithas Arturo Soria University Hospital, 28043 Madrid, Spain"},{"name":"Molecular Medicine Unit, Department of Medicine, Biomedical Research Institute of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-SACYLCSIC, 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9139-4548","authenticated-orcid":false,"given":"Eloy","family":"Esp\u00edn-Basany","sequence":"additional","affiliation":[{"name":"Colorectal Surgery, Department of General and Digestive Surgery, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"},{"name":"Department of Surgery, Universitat Aut\u00f2noma de Barcelona (UAB), 08193 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e055409","DOI":"10.1136\/bmjopen-2021-055409","article-title":"Cohort Profile: The Spanish Early-Onset Colorectal Cancer (SECOC) Cohort: A Multicentre Cohort Study on the Molecular Basis of Colorectal Cancer among Young Individuals in Spain","volume":"11","author":"Perea","year":"2021","journal-title":"BMJ Open"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"djw322","DOI":"10.1093\/jnci\/djw322","article-title":"Colorectal Cancer Incidence Patterns in the United States, 1974-2013","volume":"109","author":"Siegel","year":"2017","journal-title":"J. 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