Annals of Surgical Oncology

, Volume 10, Issue 8, pp 870–875

Adenoma Recurrences After Resection of Colorectal Carcinoma: Results From the Southwest Oncology Group 9041 Calcium Chemoprevention Pilot Study

Authors

  • David Z. J. Chu
    • City of Hope National Medical Center
  • Kari Chansky
    • Southwest Oncology Group Statistical Center
    • Southwest Oncology Group (SWOG-9041) Operations Office
  • David S. Alberts
    • University of Arizona Cancer Center
  • Frank L. MeyskensJr.
    • University of California
  • Cecilia M. Fenoglio-Preiser
    • University of Cincinnati Medical Center
  • Saul E. Rivkin
    • Puget Sound Oncology Consortium
  • Glenn M. Mills
    • Louisiana State University
  • Jeffrey K. Giguere
    • Greenville Community Clinical Oncology Program
  • Gary E. Goodman
    • Puget Sound Oncology Consortium
  • James L. Abbruzzese
    • M. D. Anderson Cancer Center
  • Scott M. Lippman
    • M. D. Anderson Cancer Center
Original Articles

DOI: 10.1245/ASO.2003.03.037

Cite this article as:
Chu, D.Z.J., Chansky, K., Alberts, D.S. et al. Ann Surg Oncol (2003) 10: 870. doi:10.1245/ASO.2003.03.037

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.

Key Words

AdenomaColorectal cancerSynchronous adenomaAdenoma recurrence rate

Copyright information

© The Society of Surgical Oncology, Inc. 2003