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CLINICAL
ANALYSIS OF COLON CANCER IN CHILDHOOD
Jokić
R1, Rebić S1,
Konstantinidis N2, Dobanovački D1,
Škorić S1,
Antić J1.
1Clinic
for pediatric surgery, University of Novi Sad, Serbia and Montenegro
2Clinic for pediatrics, University of Novi
Sad, Serbia and Montenegro
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ABSTRACT
Colorectal
carcinomas are very rare in childhood (incidence is from 2% to 6
%), and virtually all present with advanced (Duke C or D) disease.
Most pediatric cases occur in second decade of life, from 15 to
19 years. Presenting symptoms are abdominal pain, weight loss, nausea,
vomiting and constipation. Physical findings include abdominal distension,
tenderness and mass. More then one half has blood in the stool.
The time from onset of the symptoms to presentation is often several
months, perhaps because children's doctors are not keyed into malignancies
in the face of intestinal symptoms as adult colleagues. The primary
treatment is surgical resection. This article describes previously
reported experience with colon cancers in children, current indications
for chemotherapy, and general principles, which are important regarding
the operative technique. In addition, future applications for new
technology are suggested. The current study attempted to estimate
the incidence and clinical features of the abdominal malignancies
of the children under the age of 15 years managed in a single institution
between January 2001 and April 2003. There were 11 abdominal tumors
and two colon carcinomas. The children underwent surgical removal
of the colon carcinoma with wide portion of the colon involved.
Postoperatively, they were under specific protocols for chemotherapy
(5-FU). Microscopic examination confirmed operative diagnosis and
there was evidence of local infiltration and distant metastases.
Both patients with colon carcinoma died few months after the operation.
It is important to be aware of the potential for colon cancers in
pediatric patients, and to take an aggressive approach to the diagnosis
and early treatment of the disease. The role of modern chemotherapy
in children with cancer is less clear. Surgery is the mainstay of
therapy, and with a B1 lesion, one may have a survivor. |
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Keywords:
Colon cancer, Surgery, Children |
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