Metachronous colorectal cancers.
BACKGROUND
Up to 9 per cent of patients who undergo resection for colorectal cancer develop metachronous cancers. There is no consensus on the detection and management of such cancers.


METHODS
The literature was reviewed exhaustively regarding the incidence, clinical characteristics, detection, treatment and molecular genetics of metachronous colorectal cancers. This was based on a Medline search from 1966 to December 1997 for articles on metachronous colorectal cancers. A manual search was also performed on references quoted in these articles. All publications relevant to this study were included.


RESULTS
Although the underlying causes for metachronous colorectal cancers are yet to be elucidated, risk factors for the disease have been identified. These include the presence of synchronous polyps or cancers, a history of metachronous cancers, and hereditary non-polyposis colorectal cancer (HNPCC).


CONCLUSIONS
Preoperative colonoscopy and postoperative colonoscopic surveillance are essential in identifying patients at risk of metachronous colorectal cancer. A total colectomy and ileorectal anastomosis should be considered for some patients, certainly for those with HNPCC.
Department of Surgery, University College London Medical School, Whittington Hospital, UK.
O
O
Fajobi
C Y
CY
Yiu
S B
SB
Sen-Gupta
P B
PB
Boulos
D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D006801:Humans; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D012307:Risk Factors