OBJECTIVETo explore the prevalence, clinical features and prognosis of multiple primary neoplasms in patients with colorectal carcinoma (CRC).

METHODSData of colorectal cancer patients admitted to our hospital from June 1994 to June 2002 were analyzed retrospectively. Patients were divided into multiple-cancer group (MCG) and single- cancer group (SCG). Clinical features and prognosis were compared between two groups.

RESULTSThe incidence of multiple cancers was 7.4 % (83/ 1125). Forty- seven patients had multiple colorectal cancers metachronous CRC(S) in 12 and synchronous CRC(S) in 35. Thirty- six patients 5 patients with synchronous cancers had malignant tumors outside colorectal tract,12 of whom were gastric carcinomas. No significant differences were found between MCG and SCG regarding gender, onset age, Dukes stage and differentiation of index CRC. Cancer family history (P=0.002) and colorectal adenoma (P=0.036) were significantly more common in MCG than those in SCG. The local recurrence or distant metastasis in MCG was significantly higher than that in SCG (P=0.047), though there was no significant difference in survival between the two groups. Forty- one percent of index tumors were located in right colon in MCG, significantly higher than that in SCG (P=0.048). The secondary tumors were mainly adenoma cancerization in MCG.

CONCLUSIONCancer family history and colorectal adenoma seems to be at high risk for developing multiple cancers in CRC patients. Gastric cancer and colorectal adenoma cancerization were common secondary tumors of multiple primary neoplasms in patients with colorectal carcinoma.

Adenomatous Polyps ; genetics ; Adult ; Aged ; Colorectal Neoplasms ; diagnosis ; epidemiology ; pathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms, Multiple Primary ; diagnosis ; epidemiology ; pathology ; Prognosis ; Retrospective Studies ; Risk Factors

OBJECTIVETo compare the age-specific detection rates of colorectal neoplasms by colonoscopic screening among high-risk population in rural area and to provide evidence for determining the initial age in the colorectal cancer screening.

METHODSThe age-specific detection rates of colorectal cancers and adenomas, and the proportion of detected cases in each age group after screening by the optimized sequential colorectal cancer screening program in Jiashan County, Zhejiang Province, were analyzed.

RESULTSMass screening with the optimized sequential colorectal cancer screening program in Jiashan was conducted and 8867 colonoscopic examinations were performed. A total of 1811 individuals with at least one colorectal neoplastic lesion were found. Among them, there were 92 (1.04%) colorectal cancer patients, 1164 (13.13%) patients with at least one adenoma and 377 (4.25%) patients with at least one advanced adenoma. The detection rate of colorectal neoplastic lesions for the age group 40 - 44 was considerably lower than that in the age group 45 - 49. Hypothetically, to increase the initial age to 45-years for the optimized sequential colorectal cancer screening program would yield a 7.84% increase in the detection rate of total colorectal neoplastic lesions, 13.46% increase in the detection rate of colorectal cancer, 8.76% increase in the detection rate of adenoma, 12.24% increase in the detection rate of advanced adenoma and 19.64% lower in the cost of initial screening, 13.30% lower in the cost of colonoscopic screening.

CONCLUSIONSAmong the high-risk population aged 40 to 74, the detection rates of colorectal cancer and adenoma are increasing with the increase of age, the detection rates of colorectal cancer and adenoma as well as proportion of detected cases in the 40 - 44 age group are considerably lower. To increase the initial age to 45 for colorectal cancer screening in rural area of China is reasonable.

Adenoma ; diagnosis ; epidemiology ; pathology ; Adult ; Age Distribution ; Aged ; Carcinoma ; diagnosis ; epidemiology ; pathology ; China ; epidemiology ; Colitis, Ulcerative ; diagnosis ; epidemiology ; pathology ; Colonic Polyps ; diagnosis ; epidemiology ; pathology ; Colonoscopy ; Colorectal Neoplasms ; diagnosis ; epidemiology ; pathology ; Female ; Humans ; Incidence ; Male ; Mass Screening ; methods ; Middle Aged ; Risk ; Rural Population ; Surveys and Questionnaires

BACKGROUND/AIMS: The purposes of this study were to investigate various environmental factors for colon polyps and to analyze locoregional clinical characteristics of colon polyps in Gyeongju and Pohang area. METHODS: From October 2005 to September 2006, patients who underwent colonoscopy were analyzed based on their ages, genders, body mass indices (BMI), dietary habits, smoking behaviors, accompaying diseases, and medications as risk factors for the occurrence of colon polyps. Then clinical manifestations, gross appearances and pathologic findings of polyps were investigated. RESULTS: Among 253 patients enrolled, a total of 296 colon polyps were found in 108 patients. The incidence of colon polyps in more than 50-year old patients was 3.2-fold greater compared to less than 50-year old patients. Smoking habits were also significantly associated with the occurence of colon polyps. Among adenomatous polyps, tubulovillous type and moderate to severe dysplasia were frequently observed as the size increased, yet the location of polyps was not significantly associated. CONCLUSIONS: Older age and smoking habit increase the risk of colon polyps. Rectal polyps have less chance to be adenomatous type. The larger the polyp grows, the more likely it to be tubulovillous and dysplastic.
Adenomatous Polyps/pathology ; Adult ; Aged ; Aged, 80 and over ; Colonic Polyps/*diagnosis/epidemiology/pathology ; Colorectal Neoplasms/*diagnosis/epidemiology/pathology ; Female ; Humans ; Korea ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Questionnaires ; Risk Factors ; Rural Population

Colorectal cancer is the second most common cancer in males and the fourth most common in females in Korea. Since the most of colorectal cancer occur through the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are one of the most effective methods to prevent colorectal cancer. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish Korean guideline for colorectal cancer screening and polyp detection. Korean Multi-Society Take Force developed the guidelines with evidence-based methods. Parts of the statements drawn by systematic reviews and meta-analyses. Herein we discussed the epidemiology of colorectal cancers and adenomas in Korea, optimal screening methods for colorectal cancer, and detection for adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.
Adenoma/*diagnosis/epidemiology/radiography ; Age Factors ; Colonic Polyps/pathology ; Colonoscopy ; Colorectal Neoplasms/*diagnosis/epidemiology/radiography ; Databases, Factual ; Early Detection of Cancer ; Female ; Humans ; Immunohistochemistry ; Male ; Occult Blood ; Republic of Korea ; Tomography, X-Ray Computed

OBJECTIVETo study the influence of clinical and pathological-morphological parameters on the prognosis of colorectal carcinoma.

METHODSUnivariate and multivariate Cox proportional hazard model were used to study the influence of clinical and pathological-morphological factors on the prognosis in 226 colorectal carcinoma cases.

RESULTSUsing univariate analysis, data showed that the factors significantly related to disease prognosis would include: the depth of direct spread, vessel invasion, perineural invasion, tumor budding, peritumoral-lymphocytic infiltration, Crohn-like reaction, number of positive lymph nodes, distant metastasis, TNM stage and urine glucose. Multivariate Cox proportional hazard model showed that six factors were identified to be associated with higher relative-risk (RR), including: older age, advanced TNM stage, more severe budding, perineural invasion, less peritumoral-lymphocytic infiltration and urine glucose.

CONCLUSIONAge, TNM stage, tumor budding, perineural invasive, peritumoral-lymphocytic infiltration and urine glucose were independent predictors to the prognosis of colorectal carcinoma.

Aged ; China ; epidemiology ; Colorectal Neoplasms ; diagnosis ; epidemiology ; pathology ; Female ; Glycosuria ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Regression Analysis ; Retrospective Studies ; Risk Factors

OBJECTIVETo investigate the association of peripheral nerve invasion (PNI) with clinicopathological factors and prognosis of colorectal cancer.

METHODSClinicopathological data and Surgical specimens of 372 colorectal cancer patients who underwent radical resection from January 2011 to June 2012 in The Second Affiliated Hospital of Harbin Medical University were collected. Histopathological evaluation of tissue samples was conducted with hematoxylin and eosin-stained sections. PNI was considered positive when cancer cells were observed inside the nerve sheath, or when at least 33% of the nerve periphery was surrounded by cancer cells. The relationship between PNI and clinicopathological factors of colorectal cancer was analyzed by χtest or Fisher's exact test. Three-year overall survivals of PNI positive and negative patients were determined using the Kaplan-Meier method. Detection results were compared using log-rank test.

RESULTSOf 372 colorectal cancer patients, 133 (35.8%) were PNI positive. Among the PNI positive patients, 63 cases were male and 70 cases female; 76 cases were more than 60 years old and 57 cases less than 60 years old; tumors of 6 cases located in the ileocecal colon, of 33 cases in the ascending colon, of 7 cases in the transverse colon, of 8 cases in the descending colon, of 22 cases in the sigmoid colon, and of 57 cases in the rectum; tumor diameter was greater than 4 cm in 83 cases, and less than 4 cm in 50 cases; tumors of 48 cases were moderately or highly differentiated, and of 85 cases poorly-differentiation; tumor invasion depth in 2 cases, T2 in 7 cases, T3 in 93 cases, T4 in 31 cases; lymphatic metastasis was N0 phase in 56 cases, N1 in 41 cases, and N2 in 36 cases; tumors were stage I( in 2 cases, stage II( in 40 cases, of stage III( in 75 cases and stage IIII( in 16 cases. The positive rate of PNI was significantly associated with tumor location (χ=11.20, P=0.048), tumor size (χ=21.80, P=0.000), differentiation (χ=60.90, P=0.000), depth of invasion (χ=19.00, P=0.000), lymph node metastasis (χ=19.70, P=0.000) and TNM staging (χ=70.80, P=0.000), but not with sex, age or vascular invasion(P>0.05). The median follow-up time was 48 (8 to 62) months. Kaplan-Meier survival curve showed that the 3-year survival rate of PNI positive patients was 52.6%, significantly lower than that of PNI negative patients(78.3%, P=0.000). Further analysis of patients with stage II( and III( colorectal cancer showed that the 3-year survival rates of PNI positive patients were 62.3% and 43.5%, respectively, which were significantly lower than those of PNI negative patients with stage II( and III((91.7% and 79.4%), and the differences were statistically significant(P=0.000).

CONCLUSIONSPNI is a poor prognostic factor of colorectal cancer. It may be a complement of the classic TNM staging classification in stratifying colorectal cancer patients, especially in stages II( and III(.

Aged ; Colorectal Neoplasms ; diagnosis ; epidemiology ; mortality ; pathology ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Neoplasm Grading ; statistics & numerical data ; Neoplasm Invasiveness ; pathology ; physiopathology ; Neoplasm Staging ; statistics & numerical data ; Peripheral Nervous System Neoplasms ; mortality ; pathology ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Rate