Incidence and therapeutic implications of synchronous colonic pathology in colorectal adenocarcinoma

Arenas, Richard B.; Fichera, Alessandro; Mhoon, Deborah A; Michelassi, Fabrizio

doi:10.1016/s0039-6060(97)90077-5

Cited by 54 publications

(30 citation statements)

References 18 publications

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“…In synchronous colorectal cancer, because preoperative identification of concurrent lesions is vital to improved prognosis, careful colonoscopic evaluation of the whole colon is necessary (21∼22). For adequate management of multiple primary colorectal cancers, subtotal or total colectomy may occasionally be necessary (23). Colonoscopy surveillance at six-month intervals for 24∼48 months after an operations is recommended in order to achieve early detection of metachronous colorectal cancer (7).…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Multiple Primary Colorectal Cancers

et al. 2008

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Purpose: Although multiple primary colorectal cancer has been recognized as a significant clinical entity, its clinical and pathological features and its prognosis are still controversial. The purpose of this study was to clarify clinical and pathological features of multiple primary colorectal cancer.Materials and Methods: Among 1669 patients who underwent surgery for primary colorectal cancer from January 1997 to June 2005, 26 patients (1.6%) with multiple primary colorectal cancer were identified. We reviewed clinical characteristics including diagnostic interval, lesions, operating methods, and TNM stage, and we defined the index lesion as the most advanced lesion among the synchronous lesions. For the purposes of the study, the colon and rectum were classified into three segments. The right-side colon included the appendix, cecum, ascending colon, hepatic flexure, and transverse colon, and the left-side colon included the splenic flexure, descending colon, and sigmoid colon.Results: Of the 26 patients with multiple primary colorectal cancers, nineteen patients were male and seven patients were female, with a mean age of 61.5 years. Nineteen patients had synchronous colorectal cancers and seven patients had metachronous colorectal cancers. In the metachronous cases, the mean diagnostic interval was 36.8 months. The site of the first lesion in metachronous colorectal cancers was the right colon in five cases (71.4%) and the left colon in two cases (28.6%), and the site of the second lesion was the rectum in six cases (55.5%), the right colon in three cases (33.3%), and the left colon in one case. The TNM stage of the second lesions in the metachronous colorectal cancers was stage II in four cases (57.1%), stage III in one case (14.3%), and stage IV in one case (14.3%). For the synchronous colorectal cancers, the operation methods were single-segment resection combined with endoscopic mucosal resection in five cases (26.3%), single-segment resection alone in six cases, two-segment resection in six cases, and total colectomy in two cases.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Multiple Primary Colorectal Cancers

et al. 2008

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“…It is important to palpate the entire colon carefully before the end of the operation for CRC so that a misdiagnosis of SCRCs can be avoided. Unfortunately, however, such intraoperative palpation is relatively insensitive and associated with a greater than 50% failure rate in detecting lesions of SCRCs [33], especially when the tumor is at an earlier histological stage [34]. For this reason, full clinical and radiological investigation is essential prior to the operation.…”

Section: Diagnosismentioning

confidence: 99%

Synchronous Colorectal Cancers: A Review of Clinical Features, Diagnosis, Treatment, and Prognosis

2011

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Background/Aims: With the development of early diagnostic technologies, more synchronous colorectal cancers (SCRCs) can be clinically detected. Although SCRCs are recognized as a significant clinical entity, their clinical features, diagnosis, treatment, and prognosis have yet to be definitively established. In order to obtain a comprehensive understanding of this disease and to establish an efficient profile by which to recognize individuals at high risk of developing SCRCs, we carried out a review of the relevant literature. Methods: The PubMed database was searched for publications of ‘synchronous colorectal carcinoma/cancer/adenocarcinoma’ and ‘multiple colorectal carcinomas’. All publications up to January 2011 were considered, and then only articles in English were retrieved for inclusion in this review. Results: The incidence of SCRCs was found to be higher in older and male patients. The prognosis in patients with SCRCs was equivalent to that in patients with solitary CRC. The failure to diagnose synchronous lesions before and during the operation was associated with repeated surgery. Conclusion: SCRCs possess distinctive features compared to solitary CRC. While all colorectal patients should be carefully assessed to rule out the presence of concurrent colon adenomas, since missed lesions can result in additional surgery and poor prognosis, particular attention should be given to the high-risk group of older male patients.

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“…CTC has the ability to complete the colon evaluation as well as identify the cause of endoscopic failure in a large percentage of cases [9]. In cases of occlusive carcinoma, CTC can detect synchronous carcinomas [9, 10], which occur in about 5% of cases [14]. In a very recent article [10], CTC depicted 88 endoscopically nonvisualized lesions of 6 mm or larger, including 12 masses greater than 20 mm.…”

Section: Current Indications For Ctcmentioning

confidence: 99%

CT Colonography (Virtual Colonoscopy): Technique, Indications and Performance

Blachar¹

2007

Digestion

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Worldwide, colorectal cancer is the third most frequent cancer occurring in both sexes. Screening programs for early detection enable detection of tumors at an earlier stage and have been shown to reduce death rate. Currently, colonoscopy is the investigation of choice for colorectal cancer screening and for investigation of patients with suspected colorectal cancer. However, colonoscopy remains an invasive technique requiring anesthesia, with a risk of perforation and bleeding. In addition, even experienced colonoscopists may be unable to complete the colonoscopy due to multiple reasons such as severe diverticulosis, stricture, obstructing mass, or fixation of colonic loops. CT colonography, also known as virtual colonoscopy, is a relatively new technique that is becoming increasingly popular. The technical aspects, indications, advantages and diagnostic performance of this technique are briefly reviewed.

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Incidence and therapeutic implications of synchronous colonic pathology in colorectal adenocarcinoma

Cited by 54 publications

References 18 publications

Clinical Characteristics of Multiple Primary Colorectal Cancers

Clinical Characteristics of Multiple Primary Colorectal Cancers

Synchronous Colorectal Cancers: A Review of Clinical Features, Diagnosis, Treatment, and Prognosis

CT Colonography (Virtual Colonoscopy): Technique, Indications and Performance

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