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

  • David Z. J. Chu
  • Kari Chansky
  • David S. Alberts
  • Frank L. MeyskensJr.
  • Cecilia M. Fenoglio-Preiser
  • Saul E. Rivkin
  • Glenn M. Mills
  • Jeffrey K. Giguere
  • Gary E. Goodman
  • James L. Abbruzzese
  • Scott M. Lippman
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

Authors and Affiliations

  • David Z. J. Chu
    • 1
  • Kari Chansky
    • 2
    • 10
  • David S. Alberts
    • 3
  • Frank L. MeyskensJr.
    • 4
  • Cecilia M. Fenoglio-Preiser
    • 5
  • Saul E. Rivkin
    • 6
  • Glenn M. Mills
    • 7
  • Jeffrey K. Giguere
    • 8
  • Gary E. Goodman
    • 6
  • James L. Abbruzzese
    • 9
  • Scott M. Lippman
    • 9
  1. 1.City of Hope National Medical CenterDuarte
  2. 2.Southwest Oncology Group Statistical CenterSeattle
  3. 3.University of Arizona Cancer CenterTucson
  4. 4.University of CaliforniaIrvineOrange
  5. 5.University of Cincinnati Medical CenterCincinnati
  6. 6.Puget Sound Oncology ConsortiumSeattle
  7. 7.Louisiana State UniversityShreveport
  8. 8.Greenville Community Clinical Oncology ProgramGreenville
  9. 9.M. D. Anderson Cancer CenterHouston
  10. 10.Southwest Oncology Group (SWOG-9041) Operations OfficeSan Antonio