Influencing factors of metachronous tumor lesions after radical resection of rectal cancer
10.12025/j.issn.1008-6358.2025.20250387
- VernacularTitle:直肠癌根治术后异时性肿瘤性病变的影响因素
- Author:
Qiuning WU
1
;
Yongle CHEN
2
Author Information
1. Department of Gastrointestinal Endoscopy, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong, China;Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangzhou 510655, Guangdong, China;Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong, China.
2. Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangzhou 510655, Guangdong, China;Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong, China;Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong, China.
- Publication Type:Monographicreport:Endoscopicdiagnosisandtreatmentofdigestivesystemdiseases
- Keywords:
rectal cancer;
metachronous adenoma;
metachronous colorectal cancer;
colonoscope
- From:
Chinese Journal of Clinical Medicine
2025;32(5):726-733
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore risk factors for metachronous tumor lesions after radical resection of rectal cancer (RC). Methods A retrospective study was conducted on 757 RC patients who underwent RC radical surgery at the Sixth Affiliated Hospital, Sun Yat-sen University from October 2012 to June 2018. The patients were divided into early-onset RC group (EO-RC group, ＜50 years old, n=228) and average-onset RC group (AO-RC group, ≥ 50 years old, n=529) based on their age of diagnosis, and were followed up until March 2025. General information, initial colonoscopy, follow-up colonoscopy, and other relevant clinical information were collected from all patients. The risk of developing metachronous tumor lesions was compared between two groups using Kaplan Meier (K-M) risk function; univariate and multivariate Cox proportional hazards models were used to analyze the influencing factors of metachronous tumor lesions after RC radical surgery. Results The median follow-up time was 30 (15, 58) months. The K-M risk function showed that the risk of developing metachronous tumor lesions in the EO-RC group was significantly lower than that in the AO-RC group (P＜0.001). The results of the multivariate Cox proportional hazards model showed that the risk of metachronous tumor lesions after RC surgery in the EO-RC group was 50.8% of that in the AO-RC group (P＜0.001); PIK3CA mutation and synchronous advanced adenoma were independent risk factors for metachronous tumor lesions after RC surgery (HR=2.360, 2.094; P=0.003, P＜0.001). Conclusions RC patients with advanced age, PIK3CA mutations, and synchronous advanced adenomas are prone to developing metachronous tumor lesions after surgery. Patients with EO-RC may not require intensified colonoscopy surveillance postoperatively. However, intensified surveillance strategies should be considered for RC patients harboring PIK3CA mutations or presenting with synchronous advanced adenomas.
