title: Metastatic tumors to the colon and rectum: a multi-institutional study.
abstract: BACKGROUND
  Unlike the small bowel, the colorectal mucosa is seldom the site of metastatic disease. Objective.-To determine the incidence of truly colorectal metastases, and subsequent clinicopathologic findings, in a substantial colorectal cancer population collected from 7 European centers.
  
  
  METHODS
  During the last decade, 10 365 patients were identified as having colorectal malignant tumors, other than systemic diseases. Data collected included patient demographics, clinical symptoms, treatment, the presence of metastases in other sites, disease-free interval, follow-up, and overall survival. All secondary tumors resulting from direct invasion from malignant tumors of the contiguous organs were excluded, as well as those resulting from lymph node metastases or peritoneal seeding.
  
  
  RESULTS
  Only 35 patients were included (10 men) with a median age of 59 years. They presented with obstruction, bleeding, abdominal pain, or perforation. The leading source of metastases was the breast, followed by melanoma. Metastases were synchronous in 3 cases. The mean disease-free interval for the remaining cases was 6.61 years. Surgical resection was performed in 28 cases. Follow-up was available for 26 patients; all had died, with a mean survival time of 10.67 months (range, 1-41 months).
  
  
  CONCLUSIONS
  Colorectal metastases are exceptional (0.338%) with the breast as a leading source of metastases; they still represent a late stage of disease and reflect a poor prognosis. Therefore, the pathologist should be alert for the possibility of secondary tumors when studying large bowel biopsies. Any therapy is usually palliative, but our results suggest that prolonged survival after surgery and complementary therapy can be obtained in some patients.
authors.affiliation: Department of Pathology, Hôpital St-Antoine, AP-HP, 184 rue du Faubourg St-Antoine, 75012 Paris, France. najat.mourra@sat.aphp.fr
authors.forename: Najat
authors.initials: N
authors.lastname: Mourra
authors.forename: Anne
authors.initials: A
authors.lastname: Jouret-Mourin
authors.forename: Thierry
authors.initials: T
authors.lastname: Lazure
authors.forename: Virginie
authors.initials: V
authors.lastname: Audard
authors.forename: Laurence
authors.initials: L
authors.lastname: Albiges
authors.forename: Maude
authors.initials: M
authors.lastname: Malbois
authors.forename: Hanifa
authors.initials: H
authors.lastname: Bouzourene
authors.forename: Pierre
authors.initials: P
authors.lastname: Duvillard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary; D008875:Middle Aged; D011379:Prognosis