title: Synchronous polyps predict metachronous colorectal lesions after curative resection of colorectal cancer.
abstract: BACKGROUND
  The principal aim of endoscopic follow-up programs after curative resection of colorectal cancer (CRC) is to improve survival and identify local recurrence and metachronous CRC. The aim of our study was to identify the possible predictors of metachronous colorectal lesions.
  
  
  METHODS
  The records of 348 consecutive patients with CRC and who completed at least 1 year of endoscopic follow-up after surgery were analyzed. In this group, 336 patients underwent surgery for primitive CRC and 12 for metachronous cancer. Patients' characteristics, operative details, and endoscopical follow-up findings were retrieved. Multivariate survival analyses were used to identify patient categories at risk of metachronous colonic lesions.
  
  
  RESULTS
  128 patients presented a metachronous lesion: 118 adenomas and 10 adenocarcinomas. At multivariate analysis, active smoke (HR = 1.84, p = 0.03), neoadjuvant therapy (HR = 0.24, p = 0.01), and presence of synchronous polyps (HR = 1.55, p = 0.04) resulted independent predictors of metachronous adenoma after CRC removal while neoadjuvant therapy (HR = 0.25, p = 0.02), active smoke (HR = 1.54, p = 0.04), and presence of synchronous polyps (HR = 1.86, p = 0.02) resulted independent predictors of metachronous lesions after CRC removal.
  
  
  CONCLUSIONS
  This study demonstrated a high rate of metachronous lesions in the early follow-up after curative CRC resection. The negative effects of synchronous polyps should be carefully evaluated when planning patients' follow-up.
authors.affiliation: a II Department of Surgery (IV Unit) , Regional Hospital 'Cà Foncello' , Treviso , Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Pozza
authors.affiliation: a II Department of Surgery (IV Unit) , Regional Hospital 'Cà Foncello' , Treviso , Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Ruffolo
authors.affiliation: a II Department of Surgery (IV Unit) , Regional Hospital 'Cà Foncello' , Treviso , Italy.
authors.forename: Alain
authors.initials: A
authors.lastname: Fiorot
authors.affiliation: a II Department of Surgery (IV Unit) , Regional Hospital 'Cà Foncello' , Treviso , Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Padoan
authors.affiliation: b Department of Surgical, Oncological and Gastroenterological Sciences , University of Padova , Padova , Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Erroi
authors.affiliation: a II Department of Surgery (IV Unit) , Regional Hospital 'Cà Foncello' , Treviso , Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Massani
authors.affiliation: a II Department of Surgery (IV Unit) , Regional Hospital 'Cà Foncello' , Treviso , Italy.
authors.forename: Ezio
authors.initials: E
authors.lastname: Caratozzolo
authors.affiliation: a II Department of Surgery (IV Unit) , Regional Hospital 'Cà Foncello' , Treviso , Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Bonariol
authors.affiliation: c Gastroenterology Unit , Regional Hospital 'Cà Foncello' , Treviso , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ferrara
authors.affiliation: b Department of Surgical, Oncological and Gastroenterological Sciences , University of Padova , Padova , Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Norberto
authors.affiliation: d Oncological Surgery Unit , Veneto Institute of Oncology (IOV-IRCCS) , Padova , Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Castoro
authors.affiliation: a II Department of Surgery (IV Unit) , Regional Hospital 'Cà Foncello' , Treviso , Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Bassi
authors.affiliation: d Oncological Surgery Unit , Veneto Institute of Oncology (IOV-IRCCS) , Padova , Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Scarpa
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D003082:Colectomy / Q000009:adverse effects / Q000379:methods; D003113:Colonoscopy / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000473:pathology; D011127:Polyps / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Colorectal cancer; endoscopic surveillance; surgery