当前位置： SCI文献检索 > INTERNATIONAL JOURNAL OF COLORECTAL DISEASE期刊下所有文献 > Risk factors for metachronous adenoma in the residual colon of patients undergoing curative surgery for colorectal cancer.

Risk factors for metachronous adenoma in the residual colon of patients undergoing curative surgery for colorectal cancer.

Abstract：

PURPOSE:Adenoma detection in colorectal cancer survivors is poorly characterised with insufficient evidence to inform frequency of surveillance schedule. The aim of this study was to examine adenoma incidence and recurrence in patients who have undergone colorectal cancer resection with curative intent. Survival outcomes were compared to determine if the presence of adenomas could be used to identify patients at higher risk of local recurrence. METHODS:This is a retrospective observational cohort study at a single tertiary institution between 2006 and 2012. Five hundred fifteen consecutive patients with stage I-III colorectal cancer who had preoperative colonoscopy and curative surgery were included (median follow-up 56 months (36-75 months). RESULTS:In total, 352/515 (68%) patients underwent postoperative surveillance colonoscopy in the first 5 years after resection. Male gender was associated with greater risk of detecting synchronous adenoma at index colonoscopy or in the resection specimen (OR 2.35, p < 0.001). In the first 5 years after cancer surgery, synchronous adenoma, male gender and right sided primary tumour were independent predictors of metachronous lesions (OR 2.13, p = 0.009; OR 2.07, p = 0.027 and OR 2.34, p = 0.004, respectively). Presence of synchronous or metachronous adenoma had no impact upon incidence of local recurrence, overall or disease free survival. CONCLUSIONS:Patients with synchronous adenoma remain at high risk of adenoma recurrence despite undergoing colonic resection and should be considered for early endoscopic surveillance. Men and those undergoing right-sided resection have a higher risk of metachronous adenoma in the long term and may benefit from more frequent endoscopic surveillance post resection.

journal_name

Int J Colorectal Dis

journal_title

International journal of colorectal disease

authors

Patel A,Williams N,Parsons N,Ali O,Peters F,Ranat R,Shah J,Spector E,Arasaradnam RP

doi

10.1007/s00384-017-2881-x

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

1609-1616

issue

eissn

0179-1958

issn

1432-1262

pii

10.1007/s00384-017-2881-x

journal_volume

pub_type

杂志文章

在线工具

Risk factors for metachronous adenoma in the residual colon of patients undergoing curative surgery for colorectal cancer.