Multi Organ Metastasis in Early Onset Colorectal Cancer: A Single Centre Observational Study

Colorectal cancer (CRC) is a leading cause of cancer-related mortality, with early-onset CRC (EOCRC) accounting for 10–15% of cases. EOCRC usually shows up in a very advanced stage, with a tumour that is very aggressive and a high chance of metastasising to other organs, especially the liver and lungs. Understanding the metastatic patterns and underlying mechanisms is crucial for improving early detection and treatment strategies. This prospective observational study was conducted at the Department of Digestive Surgery, Dr. Moewardi General Hospital, Surakarta, Indonesia, from January 2024 to January 2025. A total of 127 patients diagnosed with CRC and multi-organ metastases were included. Data were collected from medical records, including demographics, radiological findings, and laboratory results. Patients under 18 years or those with benign conditions were excluded. Statistical analysis was performed using MS Excel, with results presented as frequencies and percentages. The majority of cases (36.23%) were in the 51–60 years age group, while 22.04% were within the EOCRC category (41–50 years). Gender distribution was nearly equal (50.40% male, 49.60% female). The most common metastatic sites were the lungs (43.54%) and liver (40.22%), followed by bones (9.22%). Rare metastases were observed in the mesentery, spleen, bladder, thyroid, prostate, appendix, and ileum. Most patients (90.12%) had metastases in two organs, while 7.88% had more widespread dissemination. The findings emphasise the increased prevalence and aggressive nature of EOCRC. The relatively high proportion of lung and bone metastases suggests a distinct metastatic pattern. The nearly equal gender distribution supports the need for gender-neutral screening and treatment approaches. The presence of rare metastatic sites highlights the necessity for comprehensive imaging and personalised therapy. EOCRC with multiorgan metastases demonstrates an aggressive disease course, necessitating an early diagnosis, comprehensive staging, and personalised treatment strategies. Future research should focus on molecular markers and targeted therapies to improve prognostication and treatment outcomes.