Incidence and risk factors of metachronous colorectal neoplasm after curative resection of colorectal cancer in Korean patients.
OBJECTIVE
Early detection and endoscopic removal of metachronous neoplasms are important preventive strategies for patients with colorectal cancer (CRC) after curative tumor resection. We aimed to determine the incidence of and the risk factors for metachronous colorectal neoplasms after curative resection for CRC.


METHODS
We retrospectively reviewed clinical data of patients who underwent curative resection for CRC at the National Cancer Center, Korea, from July 2004 to July 2007 and were followed up for a mean duration of 40.7 months. The incidence of and the risk factors for developing metachronous neoplasms were analyzed.


RESULTS
A total of 1049 patients were included in this study. A follow-up colonoscopy showed that 454 (43.3%) patients developed metachronous neoplasms, including 46 (4.4%) with advanced adenoma or cancer. Univariate analyses revealed that age ≥ 60 years, male gender, diabetes mellitus, hypertension, synchronous adenoma, synchronous multiple adenoma and synchronous advanced adenoma were associated with the development of metachronous neoplasms. Baseline risk factors associated with metachronous advanced neoplasm were age ≥ 60 years, synchronous multiple adenoma and synchronous advanced adenoma. Multivariate analysis showed that age ≥ 60 years, synchronous adenoma and diabetes mellitus were risk factors for the development of metachronous neoplasms. The cumulative incidence of metachronous neoplasms was higher in patients with these risk factors than in those without.


CONCLUSIONS
Elder age, synchronous adenoma and diabetes mellitus are risk factors for developing metachronous neoplasia. Therefore, careful surveillance colonoscopy are necessary for these patients.
Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
Su Young
SY
Lee
Byung Chang
BC
Kim
Kyung Su
KS
Han
Chang Won
CW
Hong
Dae Kyung
DK
Sohn
Sung Chan
SC
Park
Sun Young
SY
Kim
Ji-Yeon
JY
Baek
Hee Jin
HJ
Chang
Dae Yong
DY
Kim
Jae Hwan
JH
Oh
D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000453:epidemiology; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
aging; colorectal neoplasms; diabetes mellitus; metachronous adenoma; second primary neoplasms; synchronous adenoma