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KMID : 0988920180160040619
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Intestinal Research
2018 Volume.16 No. 4 p.619 ~ p.627
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Rates of metachronous adenoma after curative resection for left-sided or right-sided colon cancer
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Lam Yuk Fai
Seto Wai Kay
Tong Teresa
Cheung Ka Shing
Lo Oswens
Hung Ivan FN
Law Wai Lun
Leung Wai K
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Abstract
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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.
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KEYWORD
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Colonoscopy, Colon neoplasms, Curative colectomy, Follow up, Recurrence
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