title: Prevalence and management of colorectal neoplasia in surgically treated esophageal cancer patients.
abstract: OBJECTIVE
  The existence of other primary tumors during the treatment of esophageal cancer patients has been an important issue. Our aim is to investigate the prevalence and management of colorectal neoplasia (CRN) in surgically treated esophageal cancer patients.
  
  
  METHODS
  Between 2002 and 2008, 93 patients with esophageal cancer were surgically treated. Seventy-three patients underwent subtotal esophagectomy and 20 underwent lower esophagectomy for esophageal cancer. Colonoscopy was available for detecting CRN before and after surgery.
  
  
  RESULTS
  Eighty-nine (95.7%) of the 93 patients were screened by colonoscopy preoperatively or within a year from the operation. Thirty-nine patients (43.8%) with CRN were synchronously identified: adenoma in 34 (38.2%) and adenocarcinoma in 5 patients (5.6%). Eleven adenomas with high grade-dysplasia and 8 adenomas with low grade-dysplasia were removed endoscopically. Three superficial adenocarcinomas were endoscopically removed before surgery, and 2 adenocarcinomas were surgically removed. Seventy-four patients (83.1%) were followed using colonoscopy, and 11 subsequent CRN, including 2 superficial adenocarcinomas, were endoscopically detected in 8 patients (10.8%). The size of esophageal cancer was larger in the patients with than without CRN (p = 0.036). The body mass index in esophageal cancer patients with CRN tended to be higher than in those without CRN (p = 0.065).
  
  
  CONCLUSIONS
  We noted that esophageal cancer is frequently associated with synchronous and/or metachronous colorectal cancer and adenomas. Colonoscopy is useful to detect and manage CRN before and after esophagectomy, although a few limitations exist.
authors: Department of Surgery, Shinshu University School of Medicine, Japan. Electronic address: takeuchi_daichan@yahoo.co.jp.
authors: Daisuke
authors: D
authors: Takeuchi
authors: Department of Surgery, Shinshu University School of Medicine, Japan.
authors: Naohiko
authors: N
authors: Koide
authors: Department of Surgery, Shinshu University School of Medicine, Japan.
authors: Daisuke
authors: D
authors: Komatsu
authors: Department of Surgery, Shinshu University School of Medicine, Japan.
authors: Akira
authors: A
authors: Suzuki
authors: Department of Surgery, Shinshu University School of Medicine, Japan.
authors: Shinichi
authors: S
authors: Miyagawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D015995:Prevalence; D012189:Retrospective Studies
keywords: Colorectal adenoma; Colorectal cancer; Esophageal cancer