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Left-Sided Colectomy: One of the Important Risk Factors of Metachronous Colorectal Adenoma After Colectomy for Colon Cancer

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Abstract

Background

Patients with a history of colonic resection for cancer have an increased risk for the development of metachronous malignant lesions. However, there is a lack of data on the detection rates of premalignant lesions during colonoscopy surveillance in these patients, and the few existing studies have shown conflicting results.

Aims

To identify the risk factor of metachronous premalignant lesions after colon cancer surgery.

Methods

We retrospectively screened consecutive patients who had undergone colonic surgery to treat colon cancer at the Chungnam National University Hospital between September 2009 and April 2014. We measured polyp, adenoma, and advanced adenoma detection rates (PDR, ADR, AADR) from the second surveillance colonoscopy in patients with left-sided colectomy (LCR) or right-sided colectomy (RCR). Multivariate analysis was performed to adjust for other confounding factors.

Results

A total of 348 patients were enrolled (220 LCR patients and 128 RCR patients). The PDR, ADR, and AADR in patients in the LCR and RCR groups were 56.4, 43.6, and 11.8% and 35.9, 26.6, and 9.4%, respectively. PDR and ADR in the LCR group were significantly higher than those in the RCR group. A multivariate analysis showed that male sex, hypertension, body mass index higher than 25, and LCR (odds ratio 2.090; 95% confidence interval 1.011–4.317) were associated with adenoma recurrence.

Conclusions

The LCR group had a higher adenoma recurrence rate than the RCR group. Further studies are required to determine the optimal surveillance intervals according to the type of colonic resection.

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References

  1. Jung KW, Won YJ, Oh CM, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2014. Cancer Res Treat. 2017;49:292–305.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Pita-Fernandez S, Alhayek-Ai M, Gonzalez-Martin C, Lopez-Calvino B, Seoane-Pillado T, Pertega-Diaz S. Intensive follow-up strategies improve outcomes in nonmetastatic colorectal cancer patients after curative surgery: a systematic review and meta-analysis. Ann Oncol. 2015;26:644–656.

    Article  CAS  PubMed  Google Scholar 

  3. Samadder NJ, Curtin K, Wong J, et al. Epidemiology and familial risk of synchronous and metachronous colorectal cancer: a population-based study in Utah. Clin Gastroenterol Hepatol. 2014;12:e2071–2072.

    Article  Google Scholar 

  4. Kahi CJ, Boland CR, Dominitz JA, et al. Colonoscopy surveillance after colorectal cancer resection: recommendations of the US multi-society task force on colorectal cancer. Gastroenterology. 2016;150:e711.

    Google Scholar 

  5. Mulder SA, Kranse R, Damhuis RA, Rob JT, Kuipers EJ, van Leerdam ME. The incidence and risk factors of metachronous colorectal cancer: an indication for follow-up. Diseases of the Colon & Rectum. 2012;55:522–531.

    Article  Google Scholar 

  6. Gervaz P, Bucher P, Neyroud-Caspar I, Soravia C, Morel P. Proximal location of colon cancer is a risk factor for development of metachronous colorectal cancer: a population-based study. Dis Colon Rectum. 2005;48:227–232.

    Article  PubMed  Google Scholar 

  7. Jayasekara H, Reece JC, Buchanan DD, et al. Risk factors for metachronous colorectal cancer or polyp: a systematic review and meta-analysis. J Gastroenterol Hepatol. 2017;32:301–326.

    Article  PubMed  Google Scholar 

  8. Fuccio L, Spada C, Frazzoni L, et al. Higher adenoma recurrence rate after left- versus right-sided colectomy for colon cancer. Gastrointest Endosc. 2015;82:337–343.

    Article  PubMed  Google Scholar 

  9. Patel A, Williams N, Parsons N et al. Risk factors for metachronous adenoma in the residual colon of patients undergoing curative surgery for colorectal cancer. Int J Colorectal Dis. 2017

  10. McFall M, Woods W, Miles W. Colonoscopic surveillance after curative colorectal resection: results of an empirical surveillance programme. Colorectal Disease. 2003;5:233–240.

    Article  CAS  PubMed  Google Scholar 

  11. Aronchick CA, Lipshutz WH, Wright SH, Dufrayne F, Bergman G. A novel tableted purgative for colonoscopic preparation: efficacy and safety comparisons with Colyte and Fleet Phospho-Soda. Gastrointest Endosc. 2000;52:346–352.

    Article  CAS  PubMed  Google Scholar 

  12. Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143:844–857.

    Article  PubMed  Google Scholar 

  13. Borda A, Martínez-Peñuela JM, Borda F, Muñoz-Navas M, Jiménez FJ, Carretero C. Drawing up an individual risk index for development of metachronous neoplastic lesions in resected colorectal cancer. Revista Espanola de Enfermedades Digestivas. 2012;104:291.

    Article  PubMed  Google Scholar 

  14. Lee SY, Kim BC, Han KS, et al. Incidence and risk factors of metachronous colorectal neoplasm after curative resection of colorectal cancer in Korean patients. J Dig Dis. 2014;15:367–376.

    Article  PubMed  Google Scholar 

  15. Choe EK, Park KJ, Chung SJ, Moon SH, Ryoo SB, Oh HK. Colonoscopic surveillance after colorectal cancer resection: who needs more intensive follow-up? Digestion. 2015;91:142–149.

    Article  PubMed  Google Scholar 

  16. Laiyemo AO, Doubeni C, Sanderson AK 2nd, et al. Likelihood of missed and recurrent adenomas in the proximal versus the distal colon. Gastrointest Endosc. 2011;74:253–261.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kawai K, Ishihara S, Yamaguchi H, et al. Nomogram prediction of metachronous colorectal neoplasms in patients with colorectal cancer. Ann Surg. 2015;261:926–932.

    Article  PubMed  Google Scholar 

  18. Moon CM, Cheon JH, Choi EH, et al. Advanced synchronous adenoma but not simple adenoma predicts the future development of metachronous neoplasia in patients with resected colorectal cancer. Journal of clinical gastroenterology. 2010;44:495–501.

    PubMed  Google Scholar 

  19. Rex DK, Schoenfeld PS, Cohen J, et al. Quality indicators for colonoscopy. Gastrointest Endosc. 2015;81:31–53.

    Article  PubMed  Google Scholar 

  20. Barclay RL, Vicari JJ, Doughty AS, Johanson JF, Greenlaw RL. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy. New England Journal of Medicine. 2006;355:2533–2541.

    Article  CAS  PubMed  Google Scholar 

  21. Lee GE, Park HS, Yun KE, et al. Association between BMI and metabolic syndrome and adenomatous colonic polyps in Korean men. Obesity (Silver Spring). 2008;16:1434–1439.

    Article  Google Scholar 

  22. Jacobs ET, Ahnen DJ, Ashbeck EL, et al. Association between body mass index and colorectal neoplasia at follow-up colonoscopy: a pooling study. Am J Epidemiol. 2009;169:657–666.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Tae CH, Moon CM, Jung SA, et al. Higher body mass index is associated with an increased risk of multiplicity in surveillance colonoscopy within 5 years. Sci Rep. 2017;7:14239.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Lin CC, Huang KW, Luo JC, et al. Hypertension is an important predictor of recurrent colorectal adenoma after screening colonoscopy with adenoma polypectomy. J Chin Med Assoc. 2014;77:508–512.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea

    Gee Young Yun, Hee Seok Moon, Ju Seok Kim, Sun Hyung Kang, Eaum Seok Lee, Seok Hyun Kim, Jae Kyu Sung, Byung Seok Lee & Hyun Yong Jeong

  2. Clinical Trials Center, Chungnam National University Hospital, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea

    In Sun Kwon

Authors
  1. Gee Young Yun
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  2. Hee Seok Moon
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  3. In Sun Kwon
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  4. Ju Seok Kim
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  5. Sun Hyung Kang
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  6. Eaum Seok Lee
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  7. Seok Hyun Kim
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  8. Jae Kyu Sung
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  9. Byung Seok Lee
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  10. Hyun Yong Jeong
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Contributions

Yun GY interpreted and analyzed the data and wrote the manuscript; Moon HS designed, organized, and supervised writing of the manuscript; Jeong HY, Lee BS, and Sung JK helped with data interpretation that was used in the current study; Kang SH and Kim JS provided input and organized the data for statistical analysis; Kim SH and Lee ES helped with data analysis; Kwon IS advised for the statistical analysis; all authors approved the final version of the manuscript.

Corresponding author

Correspondence to Hee Seok Moon.

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Conflict of interest

The authors have no conflicts of interest regarding the current paper.

Ethical approval

The study was reviewed and approved by the Chungnam National University Hospital Institutional Review Board (IRB file No. CNUH 2017-11-017).

Informed consent

This study is a retrospective study using medical records, and personal information protection measures are appropriately established so that the informed consent of the subject can be exempted.

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Yun, G.Y., Moon, H.S., Kwon, I.S. et al. Left-Sided Colectomy: One of the Important Risk Factors of Metachronous Colorectal Adenoma After Colectomy for Colon Cancer. Dig Dis Sci 63, 1052–1061 (2018). https://doi.org/10.1007/s10620-018-4958-y

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  • DOI: https://doi.org/10.1007/s10620-018-4958-y

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