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Metachronous colorectal cancer in Taiwan: analyzing 20 years of data from Taiwan Cancer Registry

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Abstract

Background

The risk of metachronous colorectal cancer in patients with colorectal cancer is higher than the rate of sporadic colorectal cancer in the average population. We conducted a large-scale, population-based study, with many more clinical cases than in previously published studies, to calculate the incidence of metachronous colorectal cancer.

Methods

This is a retrospective study based on data obtained from the Taiwan Cancer Registry from 1988 to 2007. Between 1988 and 2002, we analyzed 70,906 patients who were diagnosed with colon or rectal cancer and traced the occurrence of metachronous lesions with at least 5 years of follow-up.

Results

Of these patients, 1,192 (730 males, 462 females; mean age 62.73 ± 12.92 years) developed metachronous cancers. The 15-year cumulative incidence of metachronous cancer was 1.68%. Within 2 years of the index cancer, 51.69% of the metachronous cancers appeared, and 61.27% of the metachronous cancers appeared within 3 years.

Conclusions

Most metachronous lesions were noted within 3 years of initial diagnosis of the index cancer. Surveillance colonoscopy to ensure the absence of metachronous disease is essential for patients after curative surgery within 1 year, especially for those patients who did not receive complete colonoscopy before their first operation for colorectal cancer.

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References

  1. Cali RL, Pitsch RM, Thorson AG et al (1993) Cumulative incidence of metachronous colorectal cancer. Dis Colon Rectum 36:388–393

    Article  PubMed  CAS  Google Scholar 

  2. Agrez MV, Ready R, Ilstrup D et al (1982) Metachronous colorectal malignancies. Dis Colon Rectum 25:569–574

    Article  PubMed  CAS  Google Scholar 

  3. Kiefer PJ, Thorson AG, Christensen MA (1986) Metachronous colorectal cancer: time interval to presentation of a metachronous cancer. Dis Colon Rectum 29:378–382

    Article  PubMed  CAS  Google Scholar 

  4. Luchtefeld MA, Ross DS, Zander JD et al (1987) Late development of metachronous colorectal cancer. Dis Colon Rectum 30:180–184

    Article  PubMed  CAS  Google Scholar 

  5. Evers BM, Mullins RJ, Matthews TH et al (1988) Multiple adenocarcinomas of the colon and rectum: an analysis of incidences and current trends. Dis Colon Rectum 31:518–522

    Article  PubMed  CAS  Google Scholar 

  6. Juhl G, Larson GM, Mullins R et al (1990) Six-year results of annual colonoscopy after resection of colorectal cancer. World J Surg 14:255–260

    Article  PubMed  CAS  Google Scholar 

  7. Pramateftakis MG, Hatzigianni P, Kanellos D et al (2010) Metachronous colorectal cancer. Tech Coloproctol 14:63–64

    Article  Google Scholar 

  8. Cuniffe WJ, Hasieton PS, Tweedie DEF et al (1984) Incidence of synchronous and metachronous colorectal carcinoma. Br J Surg 71:941–943

    Article  Google Scholar 

  9. Bussey HJ, Wallace MH, Morson BC (1967) Metachronous carcinoma of the large intestine and intestinal polyps. Proc R Soc Med 60:208–210

    PubMed  CAS  Google Scholar 

  10. Heald RJ, Lockhart-Mummery HE (1972) The lesion of the second cancer of the large bowel. Br J Surg 59:16–19

    Article  PubMed  CAS  Google Scholar 

  11. Travieso CR Jr, Knoepp LF Jr, Hanley PH (1972) Multiple adenocarcinomas of the colon and rectum. Dis Colon Rectum 15:1–6

    Article  PubMed  Google Scholar 

  12. Moertel CG, Bargen JA, Dockerty MB (1958) Multiple carcinomas of the large intestine. A review of the literature and a study of 261 cases. Gastroenterology 34:85–98

    PubMed  CAS  Google Scholar 

  13. Park IJ, Yu CS, Kim HC et al (2006) Metachronous colorectal cancer. Colorectal Dis 8:323–327

    Article  PubMed  CAS  Google Scholar 

  14. Ballesté B, Bessa X, Piñol V et al (2007) Detection of metachronous neoplasms in colorectal cancer patients: identification of risk factors. Dis Colon Rectum 50:971–980

    Article  PubMed  Google Scholar 

  15. Maruyama H, Hasuike Y, Furukawa J et al (1992) Multiple colorectal carcinomas and colorectal carcinoma associated with extracolonic malignancies. Surg Today 22:99–104

    Article  PubMed  CAS  Google Scholar 

  16. Fukutomi Y, Moriwaki H, Nagase S et al (2002) Metachronous colon tumors: risk factors and rationale for the surveillance colonoscopy after initial polypectomy. J Cancer Res Clin Oncol 128:569–574

    Article  PubMed  Google Scholar 

  17. Parry S, Win AK, Parry B et al (2011) Metachronous colorectal cancer risk for mismatch repair gene mutation carriers: the advantage of more extensive colon surgery. Gut 60:950–957

    Article  PubMed  Google Scholar 

  18. Safi F, Beyer HG (1993) The value of follow-up after curative surgery of colorectal carcinoma. Cancer Detect Prev 17:417–424

    PubMed  CAS  Google Scholar 

  19. Rex DK, Kahi CJ, Levin B et al (2006) Guidelines for colonoscopy surveillance after cancer resection: a consensus update by the American Cancer Society and US Multi-Society Task Force on Colorectal Cancer. CA Cancer J Clin 56:160–167

    Article  PubMed  Google Scholar 

  20. Morson B (1974) President’s address. The polyp-cancer sequence in the large bowel. Proc R Soc Med 67:451–457

    PubMed  CAS  Google Scholar 

  21. van Rijn JC, Reitsma JB, Stoker J et al (2006) Polyp miss rate determined by tandem colonoscopy: a systematic review. Am J Gastroenterol 101:343–350

    Article  PubMed  Google Scholar 

  22. Farrar WD, Sawhney MS, Nelson DB et al (2006) Colorectal cancers found after a complete colonoscopy. Clin Gastroenterol Hepatol 4:1259–1264

    Article  PubMed  Google Scholar 

  23. Bressler B, Paszat LF, Chen Z et al (2007) Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population based analysis. Gastroenterology 132:96–102

    Article  PubMed  Google Scholar 

  24. Kaminski MF, Regula J, Kraszewska E et al (2010) Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med 362:1795–1803

    Article  PubMed  CAS  Google Scholar 

  25. Milsom JW, Shukla PJ (2011) Should intraoperative colonoscopy play a role in the surveillance for colorectal cancer? Dis Colon Rectum 54:504–506

    Article  PubMed  Google Scholar 

  26. Salz T, Weinberger M, Ayanian JZ et al (2010) Variation in use of surveillance colonoscopy among colorectal cancer survivors in the United States. BMC Health Serv Res 10:256

    Article  PubMed  Google Scholar 

  27. Viehl CT, Ochsner A, von Holzen U et al (2010) Inadequate quality of surveillance after curative surgery for colon cancer. Ann Surg Oncol 17:2663–2669

    Article  PubMed  Google Scholar 

  28. Scheer A, Auer RA (2009) Surveillance after curative resection of colorectal cancer. Clin Colon Rectal Surg 22:242–250

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by a grant from Landseed Hospital (LS-2010-18).

Conflict of interest

The authors declare that they have no conflict of interest.

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Corresponding author

Correspondence to Tzu-An Chen.

Additional information

T.-A. Chen and J.-T. Horng contributed equally to this work.

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Chen, TA., Horng, JT. & Lin, WC. Metachronous colorectal cancer in Taiwan: analyzing 20 years of data from Taiwan Cancer Registry. Int J Clin Oncol 18, 267–272 (2013). https://doi.org/10.1007/s10147-011-0373-5

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  • DOI: https://doi.org/10.1007/s10147-011-0373-5

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