title: Adenoma recurrences after resection of colorectal carcinoma: results from the Southwest Oncology Group 9041 calcium chemoprevention pilot study.
abstract: 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.
authors.affiliation: City of Hope National Medical Center, Duarte, California, USA.
authors.forename: David Z J
authors.initials: DZ
authors.lastname: Chu
authors.forename: Kari
authors.initials: K
authors.lastname: Chansky
authors.forename: David S
authors.initials: DS
authors.lastname: Alberts
authors.forename: Frank L
authors.initials: FL
authors.lastname: Meyskens
authors.forename: Cecilia M
authors.initials: CM
authors.lastname: Fenoglio-Preiser
authors.forename: Saul E
authors.initials: SE
authors.lastname: Rivkin
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Mills
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Giguere
authors.forename: Gary E
authors.initials: GE
authors.lastname: Goodman
authors.forename: James L
authors.initials: JL
authors.lastname: Abbruzzese
authors.forename: Scott M
authors.initials: SM
authors.lastname: Lippman
mesh_terms: 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
chemical_list: D002119:Calcium Carbonate