Metachronous colorectal adenocarcinomas

Tsantilas, Dimitrios; Ntinas, A.; Petras, Panagiotis; Zambas, Neophytos; Mogrambi, S. Al; Frangandreas, G.; Spyridis, Charalampos; Gerasimidis, Thomas

doi:10.1007/s10151-004-0157-2

Cited by 11 publications

(11 citation statements)

References 7 publications

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“…In our case also we did extended right hemicolectomy beyond splenic flexure along with mesocolon with intermediate lymph nodes. Some others believe in limited resection particularly in advanced age [12]. Rest of the chemo-radiation treatment is same as single cancer lesion.…”

Section: Discussionmentioning

confidence: 99%

Synchronous Primary Carcinoma of the Colon – A case report and review of literature

Tati¹,

Jagdish²,

KV³

et al. 2014

IOSRJDMS

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Section: Discussionmentioning

confidence: 99%

Synchronous Primary Carcinoma of the Colon – A case report and review of literature

Tati¹,

Jagdish²,

KV³

et al. 2014

IOSRJDMS

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“…In the revised bibliography, we found several studies designed with a similar purpose (30)(31)(32). However, these authors analyzed a scarce number of variables.…”

Section: Discussionmentioning

confidence: 99%

Drawing up an individual risk index for development of metachronous neoplastic lesions in resected colorectal cancer

Borda

Martínez-Peñuela²,

Borda

et al. 2012

Rev. esp. enferm. dig.

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Aim: to identify possible risk factors for the development of metachronous lesions in colorectal cancer (CRC) which would allow to establish a post-surgical individual prognostic index.Patients and methods: three hundred eighty-two surgically treated CRC were reviewed. We compared the incidence of metachronous lesions in 40 variables concerning patient clinical data and initial neoplastic findings. An individual risk index for metachronicity was drawn up including those variables which presented significant differences in multivariate logistic regression, dividing patients into three groups.Results: variables with prognostic value for metachronicity were distal cancer location: OR= 2.30 (1.03-5.13), alcohol intake: OR = 2.20 (1.08-4.48), presence of synchronous adenomas: isolated: OR = 2.47 (1.03-4.48), multiple: OR = 4.26 (1.78-10.17), and presence of synchronous advanced adenoma: OR= 2.91 (1.52-12.60). Tumor MUC-5 expression proved to have a protective role: ). An individual risk score was established considering these variables and patients could be classified into three groups, with a discrimination power for metachronicity of p< 0.0000001. Classification in high and low risk groups had a sensitivity = 75.32%, specificity = 84.21%, positive predictive value = 75.34%, negative predictive value = 92.31% and global diagnostic accuracy = 80.75%.Conclusions: the identification of risk factors for the development of metachronous lesions allow to calculate, at the time of surgical treatment, an individual prognostic index and to classify patients into three different risk groups. In high and low risk groups, both specificity and accuracy were acceptable for the prognosis of metachronous lesions, being remarkable the negative predictive power of our classification, which could become relevant when planning a different endoscopic follow up of these patients.Key words: Colorectal cancer. Follow-up. Metachronous lesions. INTRODUCTIONThe majority of colorectal cancers (CRC) are sporadic cases (1,2) and little is known about metachronous or synchronous neoplasms development (3,4). These multicentric lesions could be due to mutations in genes related to apoptosis, cellular proliferation or DNA repairing (5), or forms of hereditary non polyposis colorectal cancer syndrome with low penetrance (6). Finally, this tumor multicentricity could be caused by multiple interacting factors, such as personal or familial predisposition, environmental mechanisms, morphological or immunophenotypical tumor features which would favoured an increased risk of neoplasm development along different colonic sites (7). Once the tumor and all the possible synchronic lesions are endoscopically or surgically resected, the tumor multicentricity might promote the development of new neoplastic lesions (8,9). Similar to synchronous lesions, metachronic neoplasms will be adenomas in most cases and less frequently CRC. There are several publications related to development of metachronous lesions after the resection of the initial polyps in patient...

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“…Nuestra frecuencia de cáncer metacró-nico ha sido del 1,8%, cifra concordante con la de la mayoría de las series, que fluctúan entre el 1 y el 5% [8][9][10][11][12]31 y muy similar a la de un reciente estudio que incluye 19 hospitales españoles, que registraba una incidencia del 1,9 % 13 . La frecuencia del hallazgo de cánceres metacrónicos puede estar relacionada con el tipo de exploraciones empleadas para su diagnóstico, considerándose como la más adecuada la práctica de colonoscopias completas 32 , como en nuestra serie.…”

Section: Discussionunclassified

“…La incidencia de lesiones metacrónicas presenta importantes variaciones en los diferentes trabajos publicados [8][9][10][11][12] , siendo muy escasos los datos referentes a España 13 y careciendo de ellos en nuestra comunidad.…”

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Study of colorectal metachronous neoplastic lesions

Borda

Muñoz-Navas

Martínez-Peñuela

et al. 2010

An Sist Sanit Navar

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Fundamento. Analizar la frecuencia y las características de las lesiones neoplásicas metacrónicas, carcinomas y adenomas, tras la resección de un cáncer colo-rectal (CCR). Pacientes y métodos.Revisamos 382 CCR operados y seguidos mediante colonoscopias completas en dos hospitales de nuestra comunidad. Analizamos las lesiones metacró-nicas registradas valorando su localización, momento del diagnóstico, histología, número y tamaño. Estudiamos la frecuencia de adenomas de aparición precoz (12 meses), comparando su tamaño con respecto al resto de lesiones.resultados. La mediana de seguimiento fue de 48 meses (12-112), con 2,74±1,47 colonoscopias/caso. Diagnosticamos 7 cánceres metacrónicos (1,8%), 4 de ellos en estadio I. La mediana de tiempo hasta su diagnóstico fue de 24 meses (13-54). Registramos adenomas metacrónicos en 162 casos (42,4%), sin diferencias entre los dos hospitales: 42,1% vs. 43,8% (p=0,88). Un 6,3% de los pacientes presentaron adenomas avanzados. En 164 casos en que el primer control se efectuó a los 12 meses, la incidencia de adenomas fue del 24%. Los adenomas fueron mayoritariamente únicos (60,8%) y menores de 5 mm (68,5%). En un 55,5% de los casos con pólipos, alguno tenía una localización proximal. El diagnóstico se realizó en la 1ª exploración (56,2%), 2ª (27,8%) ó 3ª (9%). La mediana de tiempo hasta el diagnóstico fue de 21 meses (12-112) para el adenoma simple y de 35 (12-112) para el avanzado.conclusiones. Nuestro seguimiento permitió aplicar un tratamiento teóricamente curativo en la mayoría de los carcinomas metacrónicos diagnosticados. La alta incidencia de adenomas y su frecuente localización proximal hacen necesario un seguimiento con colonoscopias completas, que debería iniciarse al año de la operación y podría pasar a ser menos estricto tras tres exploraciones consecutivas sin pólipos.Palabras clave. Cáncer colo-rectal. Carcinoma metacróni-co. Adenoma metacrónico. aBstractBackground. To analyse the frequency and characteristics of metachronous neoplastic lesions, carcinomas and adenomas, following resection of colorectal cancer. Patients and methods.We reviewed 382 patients subjected to CCR operations and followed up through complete colonoscopies in two hospitals in our province. We analysed the metachronous lesions registered, evaluating their localisation, time of diagnosis, histology, number and size. We studied the frequency of early adenomas (12 months), comparing their size with the rest of the lesions.results. The average follow-up was 48 months (12-112), with 2.74±1.47 colonoscopies/case. We diagnosed 7 metachronous cancers (1.8%), 4 of them in stage I. The average time until their diagnosis was 24 months (13-54). We registered metachronous adenomas in 162 cases (42.4%), without differences between the two hospitals: 42.1% vs. 43.8% (p=0.88). Six point three percent of the patients presented advanced adenomas. In 164 cases where the control was carried out after 12 months, the incidence of adenomas was 24%. In the majority of cases, the adenomas were sole (60.8%) and smalle...

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Metachronous colorectal adenocarcinomas

Cited by 11 publications

References 7 publications

Synchronous Primary Carcinoma of the Colon – A case report and review of literature

Synchronous Primary Carcinoma of the Colon – A case report and review of literature

Drawing up an individual risk index for development of metachronous neoplastic lesions in resected colorectal cancer

Study of colorectal metachronous neoplastic lesions

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