Adenoma recurrences after resection of colorectal carcinoma: results from the Southwest Oncology Group 9041 calcium chemoprevention pilot study.
BACKGROUND
Colorectal adenomas are the usual precursors to carcinoma in sporadic and hereditary colorectal cancers (CRC).


METHODS
A total of 220 CRC patients (stages 0, I, and II) were randomized prospectively in a double-blind pilot study of calcium chemoprevention by using recurrent colorectal adenomas as a surrogate end point. This trial is still in progress, and we report the preliminary findings on adenoma recurrence rates.


RESULTS
Synchronous adenomas were present in 60% of patients, and cancer confined in a polyp was present in 23% of patients. The overall cumulative adenoma recurrence rate was 31% (19% in the first year, 29% for 2 years, and 35% for 3 years). The recurrence rates were greater for patients with synchronous adenomas: 38% at 3 years (P =.01). Lower stage was associated with higher adenoma recurrence rates (P =.04). Factors including age, sex, site of primary cancer, and whether the cancer was confined to a polyp were not significantly associated with differences in adenoma recurrence rates.


CONCLUSIONS
The substantial adenoma recurrence rate in patients resected of CRC justifies colonoscopic surveillance on a periodic basis. Patients with higher rates of adenoma recurrences, such as CRC with synchronous adenomas, are ideal subjects for chemoprevention trials.
Chu
David Z J
DZ
City of Hope National Medical Center, Duarte, California, USA.
Chansky
Kari
K
Alberts
David S
DS
Meyskens
Frank L
FL
Fenoglio-Preiser
Cecilia M
CM
Rivkin
Saul E
SE
Mills
Glenn M
GM
Giguere
Jeffrey K
JK
Goodman
Gary E
GE
Abbruzzese
James L
JL
Lippman
Scott M
SM
D000236:Adenoma / Q000473:pathology* / Q000517:prevention & control / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002119:Calcium Carbonate / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000517:prevention & control / Q000601:surgery; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary; D010865:Pilot Projects; D011446:Prospective Studies
D002119:Calcium Carbonate