Patients with colorectal cancer have a high risk of developing metachronous neoplasms.
Dr Belen Ballesté and colleagues from Spain assessed whether predictive factors associated with such conditions would allow individualized follow-up strategies in these patients.
The researchers identified individual and familial factors associated with the development of metachronous colorectal neoplasms in patients with colorectal cancer.
|Metachronous neoplasm was associated with history of previous colorectal cancer|
|Diseases of the Colon & Rectum|
The team undertook a prospective, multicenter, general population-based study.
The research team assessed 353 patients with colorectal cancer attended in 10 Spanish hospitals during a 1-year period.
Patients with familial adenomatous polyposis or inflammatory bowel disease were excluded.
All patients were monitored by colonoscopy within 2 years of the diagnosis.
The researchers evaluated demographic, clinical, pathologic, microsatellite instability status and immunohistochemistry for MSH2 and MLH1.
In addition, familial characteristics were analyzed.
At 2 years of follow-up, colonoscopy revealed the presence of adenomas in 25% of patients, and colorectal cancer in 4% of patients.
Univariate analysis demonstrated that development of metachronous neoplasm was associated with personal history of previous colorectal cancer.
The team noted that metachronous neoplasm was also associated with the presence of previous or synchronous adenomas.
Although nonstatistical significance was achieved, metachronisms were associated with gender, and differentiation degree.
Multivariate analysis identified previous or synchronous adenomas as an independent predictive factor.
The team observed that the presence of tumor DNA microsatellite instability was not correlated with the presence of metachronous neoplasma.
Family history correlated with the presence of metachronous neoplasms.
Dr Ballesté's team concluded, "Patients with previous or synchronous colorectal adenoma have an increased risk of developing metachronous colorectal neoplasms."
"Accordingly, this subgroup of patients may benefit from specific surveillance strategies."