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Postoperative adjuvant chemotherapy is associated with a lower incidence of colorectal adenomas in patients with previous colorectal cancer.

Abstract：

BACKGROUND AND AIMS:The effects of chemotherapeutic agents on the development of colorectal adenomas in patients with previous colorectal cancer (CRC) are not defined. Therefore, we evaluated the potential effect of adjuvant chemotherapy on the incidence of colorectal adenomas in patients with previous CRC. METHODS:We selected patients with low-risk stage II CRC with or without postoperative 5-fluorouracil-based adjuvant chemotherapy to reduce selection bias. Among 1808 patients with stage II CRC who underwent colonoscopic surveillance after curative resection of CRC between 2006 and 2013, 192 patients were retrospectively enrolled in this study after matching for age and sex. The patients were divided into 96 patients receiving and 96 patients not receiving 5-fluorouracil-based chemotherapy. RESULTS:Forty patients (41.7%) exhibited colorectal adenomas among 96 patients who received adjuvant chemotherapy, compared with 50 patients (52.1%) with colorectal adenomas among 96 patients who received surgery only. The incidence rate of advanced adenoma was significantly lower in the chemotherapy group than in the nonchemotherapy group (3.1% vs 10.4%, P = .044). After adjustment for clinically relevant factors such as body mass index, aspirin use, metformin use, number of follow-up colonoscopies, and operation type, adjuvant chemotherapy was found to be associated with a decreased incidence of advanced adenoma (odds ratio, .151; 95% confidence interval, .035-.653; P = .011) in patients with stage II CRC. CONCLUSIONS:The results showed that chemotherapy in patients with CRC may be associated with a lower risk of colorectal advanced adenoma development.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Lee HS,Kim SB,Lee HJ,Park SJ,Hong SP,Cheon JH,Kim WH,Kim TI

doi

10.1016/j.gie.2017.04.004

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

688-694.e2

issue

3

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(17)31806-0

journal_volume

87

pub_type

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