Rates of metachronous adenoma after curative resection for left-sided or right-sided colon cancer.
- Author:
Yuk Fai LAM
1
;
Wai Kay SETO
;
Teresa TONG
;
Ka Shing CHEUNG
;
Oswens LO
;
Ivan FN HUNG
;
Wai Lun LAW
;
Wai K LEUNG
Author Information
- Publication Type:Original Article
- Keywords: Colonoscopy; Colon neoplasms; Curative colectomy; Follow up; Recurrence
- MeSH: Adenoma*; Colon*; Colon, Transverse; Colonic Neoplasms*; Colonoscopy; Colorectal Neoplasms; Follow-Up Studies; Humans; Male; Multivariate Analysis; Polyps; Rectal Neoplasms; Recurrence
- From:Intestinal Research 2018;16(4):619-627
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: We determined the rates of metachronous colorectal neoplasm in colorectal cancer (CRC) patients after resection for right (R)-sided or left (L)-sided cancer. METHODS: Consecutive CRC patients who had undergone surgical resection for curative intent in our hospital between 2001 and 2004 were identified. R-sided colonic cancers refer to cancer proximal to splenic flexure whereas L-sided cancers include rectal cancers. Patients were included only if they had a clearing colonoscopy performed either before or within 6 months after the operation. Findings of surveillance colonoscopy performed up to 5 years after colonic resection were included in the analysis. RESULTS: Eight hundred and sixty-three CRC patients underwent curative surgical resection during the study period. Three hundred and twenty-seven patients (107 R-sided and 220 L-sided) fulfilled the inclusion criteria and had at least 1 postoperative surveillance colonoscopy performed. The proportion of patients who had polyp and adenoma on surveillance colonoscopy was significantly higher among patients with L-sided than R-sided cancers (polyps: 30.9% vs. 19.6%, P=0.03; adenomas: 25.5% vs. 13.1%, P=0.01). The mean number of adenoma per patient on surveillance colonoscopy was also higher for patients with L-sided than R-sided tumors (0.52; 95% confidence interval [CI], 0.37–0.68 vs. 0.22; 95% CI, 0.08–0.35; P < 0.01). Multivariate analysis showed that L-sided cancers, age, male gender and longer follow-up were independent predictors of adenoma detection on surveillance colonoscopy. CONCLUSIONS: Patients with Lsided cancer had a higher rate of metachronous polyps and adenoma than those with R-sided cancer on surveillance colonoscopy.
