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Villous component as a marker for synchronous and metachronous colorectal adenomas


To determine whether patients with colorectal adenomas containing a villous component (+vc group) have a higher incidence of synchronous or metachronous colorectal adenomas, 527 consecutive cases of completely removed colorectal adenoma were used. Synchronous adenomas were detected in 22.6 percent and 19.0 percent of the patients in the +vc and −vc groups, respectively. In the analysis of metachronous adenomas, 164 patients who had been followed for 1 to 11 years (mean, 3.31 years) were included. The cumulative adenoma-free rate according to Kaplan-Meier tended to be lower in the +vc group, the difference being statistically significant 1.0 to 1.2 years after treatment of the initial adenoma and the two curves being different based on the generalized Wilcoxon test. The numbers of newly detected adenomas annually were 1.76 and 0.86, and their annual incidences were 1.09 and 0.59 times, in the +vc and −vc groups, respectively. These results suggest the importance of the villous component as a predictor of metachronous colorectal adenomas.

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  1. 1.

    Winawer SJ, Sherlock P. Surveillance for colorectal cancer in average-risk patients, familial high-risk groups, and patients with adenomas. Cancer 1982;50:2609–14.

  2. 2.

    Olsen HW, Lawrence WA, Snook CW, Mutch WM. Review of recurrent polyps and cancer in 500 patients with initial colonoscopy for polyps. Dis Colon Rectum 1988;31:222–7.

  3. 3.

    Slater G, Fleshner P, Aufses AH Jr. Colorectal cancer location and synchronous adenomas. Am J Gastroenterol 1988;83:832–6.

  4. 4.

    Barkin JS, Cohen ME, Flaxman M,et al. Value of a routine follow-up endoscopy program for the detection of recurrent colorectal carcinoma. Am J Gastroenterol 1988;88:1355–60.

  5. 5.

    Henry LG, Condon RE, Schulte WJ, Aprahamian C, DeCosse JJ. Risk of recurrence of colon polyps. Ann Surg 1975;182:511–5.

  6. 6.

    Neugut AI, Johnsen CM, Forde KA, Treat MR. Recurrence rates for colorectal polyps. Cancer 1985;55:1586–9.

  7. 7.

    Brahme F, Ekelund GR, Nordén JG, Wenckert A. Metachronous colorectal polyps: comparison of development of colorectal polyps and carcinomas in persons with and without histories of polyps. Dis Colon Rectum 1974;17:166–71.

  8. 8.

    Stulc JP, Petrelli NJ, Herrera L, Mittelman A. Colorectal villous and tubulovillous adenomas equal to or greater than four centimeters. Ann Surg 1988;207:65–71.

  9. 9.

    Jahadi MR, Baldwin A Jr. Villous adenomas of the colon and rectum. Am J Surg 1975;130:729–32.

  10. 10.

    Quan SH, Castro EB. Papillary adenomas (villous tumors): a review of 215 cases. Dis Colon Rectum 1971;14:267–80.

  11. 11.

    Southwood WF. Villous tumours of the large intestine: their pathogenesis, symptomatology, diagnosis and management. Ann R Coll Surg Engl 1962;30:23–45.

  12. 12.

    Thomson JP. Treatment of sessile villous and tubulovillous adenomas of the rectum: experience of St. Mark's Hospital, 1963–1972. Dis Colon Rectum 1977;20:467–72.

  13. 13.

    Christiansen J, Kirkegaard P, Ibsen J. Prognosis after treatment of villous adenomas of the colon and rectum. Ann Surg 1979;189:404–8.

  14. 14.

    Pollard SG, Macfarlane R, Everett WG. Villous tumours of the large bowel. Br J Surg 1988;75:910–2.

  15. 15.

    Galandiuk S, Fazio VW, Jagelman DG,et al. Villous and tubulovillous adenomas of the colon and rectum: a retrospective review, 1964–1985. Am J Surg 1987;153:41–7.

  16. 16.

    Breslow NE, Day NE. Statistical methods in cancer research. Vol. I. Lyon: IARC Scientific Publications, 1980:49–53.

  17. 17.

    Schwabe AD, Lewin KJ. Benign tumors of the colon. In: Bockus HL, ed. Gastroenterology. Vol. IV. 4th ed. Philadelphia: WB Saunders, 1985:2490–516.

  18. 18.

    Muto T, Bussey HJR, Morson BC. The evolution of cancer of the colon and rectum. Cancer 1975;36:2251–70.

  19. 19.

    Colton T. Statistics in medicine. Boston: Little, Brown and Company, 1974.

  20. 20.

    Ansher AF, Lewis JH, Fleisher DE,et al. Hyperplastic colonic polyps as a marker for adenomatous colonic polyps. Am J Gastroenterol 1989;84:113–7.

  21. 21.

    Sato E, Ouchi A, Sasano N, Ishidate T. Polyps and diverticulosis of large bowel in autopsy population of Akita prefecture, compared with Miyagi: high risk for colorectal cancer in Japan. Cancer 1976;37:1316–21.

  22. 22.

    Konishi F, Morson BC. Pathology of colorectal adenomas: a colonoscopic survey. J Clin Pathol 1982;35:830–41.

  23. 23.

    Appel MF, Spjut HJ, Estrada RG. The significance of villous component in colonic polyps. Am J Surg. 1977;134:770–1.

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Correspondence to Dr. Seiji Miura M.D..

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Miura, S., Shikata, J. & Hosoda, Y. Villous component as a marker for synchronous and metachronous colorectal adenomas. Dis Colon Rectum 35, 1148–1153 (1992).

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Key words

  • Villous tumor
  • Villous component
  • Synchronous adenoma
  • Metachronous adenoma
  • Colon
  • Rectum