Predictive factors for detecting colorectal carcinomas in surveillance colonoscopy after colorectal cancer surgery

Citation
K. Togashi et al., Predictive factors for detecting colorectal carcinomas in surveillance colonoscopy after colorectal cancer surgery, DIS COL REC, 43(10), 2000, pp. S47-S53
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenerology and Hepatology
Journal title
DISEASES OF THE COLON & RECTUM
ISSN journal
0012-3706 → ACNP
Volume
43
Issue
10
Year of publication
2000
Supplement
S
Pages
S47 - S53
Database
ISI
SICI code
0012-3706(200010)43:10<S47:PFFDCC>2.0.ZU;2-X
Abstract
PURPOSE: The aim of this study was to identify the high-risk groups for met achronous colorectal carcinoma among patients who undergo colorectal cancer surgery. METHODS: Three hundred forty-one patients undergoing colorectal c ancer surgery who had undergone surveillance colonoscopy at least twice dur ing a period of more than three years were analyzed. A metachronous colorec tal carcinoma was defined as a new colorectal carcinoma detected by surveil lance colonoscopy after surgery. RESULTS: Surveillance colonoscopy was perf ormed 4.6 times per patient during an average of 6.2 years. Twenty-two meta chronous colorectal carcinomas in 19 patients were detected, and 14 (64 per cent) of 22 were detected within five years of surgery. The cumulative inci dence of developing colorectal carcinomas during a five-year period was 5.3 percent. Seventeen (77 percent) of 22 carcinomas were 10 mm or less in siz e. Ten (71 percent) of the 14 carcinomas in early stages showed a flat appe arance. Univariate analysis showed that extracolonic malignancy, coexistenc e of adenoma, and synchronous multiple colorectal carcinoma were significan t predictive factors for detecting colorectal carcinomas in surveillance co lonoscopy and that family history of colorectal carcinoma was a possible pr edictive factor. Multivariate analysis performed with Cox proportional haza rds regression model showed that extracolonic malignancy and the coexistenc e of adenoma were significant predictive factors. CONCLUSION: We recommend that patients with the above predictive factors receive surveillance colono scopy meticulously and regularly.