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Synchronous Colorectal Neoplasms in Patients With Colorectal Cancer: Predisposing Individual and Familial Factors

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

PURPOSE:

Patients with colorectal cancer have an increased risk for developing synchronous and metachronous neoplasms. However, besides those cases with inherited disorders predisposing to tumor multicentricity, it is unknown which patients are prone to this condition. This study was designed to identify individual and familial characteristics associated with the development of synchronous colorectal neoplasms in patients with colorectal cancer.

METHODS:

During a one-year period, all patients with colorectal cancer attended in 25 Spanish hospitals were included. Exclusion criteria were colorectal cancer developed in the context of familial adenomatous polyposis or inflammatory bowel disease, refusal to participate in the study, incomplete family history, and inadequate examination of the colon and rectum. In addition to demographic, clinical, pathology, molecular (microsatellite instability status), and familial characteristics, presence of synchronous colorectal neoplasms (adenoma or carcinoma) were analyzed.

RESULTS:

A total of 1,522 patients were included in the study. Synchronous colorectal neoplasms were documented in 505 patients (33.2 percent): adenoma (n = 411), carcinoma (n = 27), or both (n = 67). Development of these lesions was associated with male gender (odds ratio, 1.94; 95 percent confidence interval, 1.43–2.65), personal history of colorectal adenoma (odds ratio, 3.39; 95 percent confidence interval, 1.58–7.31), proximal location of primary tumor (odds ratio, 1.40; 95 percent confidence interval, 1.02–1.94), tumor TNM Stage II (odds ratio, 1.31; 95 percent confidence interval, 1.15–4.66), mucinous carcinoma (odds ratio, 1.89; 95 percent confidence interval, 1.19–2.99), and family history of gastric cancer (odds ratio, 2.03; 95 percent confidence interval, 1.17–3.52).

CONCLUSIONS:

Based on individual and familial characteristics associated with synchronous colorectal neoplasms, it has been possible to identify a subgroup of patients with colorectal cancer prone to tumor multicentricity with potential implications on the delineation of preventive strategies.

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Author information

Authors and Affiliations

  1. For the Gastrointestinal Oncology Group of the Spanish Gastroenterological Association, (see Appendix)

    Virgínia Piñol M.D., Montserrat Andreu M.D., Antoni Castells M.D., Artemio Payá M.D., Xavier Bessa M.D. & Rodrigo Jover M.D.

  2. Department of Gastroenterology, IMD, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain

    Virgínia Piñol M.D. & Antoni Castells M.D.

  3. Department of Gastroenterology, Hospital del Mar, Barcelona, Catalonia, Spain

    Montserrat Andreu M.D. & Xavier Bessa M.D.

  4. Department of Pathology, Hospital General d’ Alacant, Alacant, Spain

    Artemio Payá M.D.

  5. Department of Gastroenterology, Hospital General d’Alacant, Alacant, Spain

    Rodrigo Jover M.D.

Authors
  1. Virgínia Piñol M.D.
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  2. Montserrat Andreu M.D.
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  3. Antoni Castells M.D.
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  4. Artemio Payá M.D.
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  5. Xavier Bessa M.D.
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  6. Rodrigo Jover M.D.
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Corresponding author

Correspondence to Montserrat Andreu M.D..

Additional information

Supported by grants from the Fondo de Investigación Sanitaria (FIS 01/0104-01, 01/0104-02, and 01/0104-03), from the Instituto de Salud Carlos III (RC03/02 and RC03/10), and from Merck, Sharp and Dhome, Spain. Virgínia Piñol, M.D. received a research grant from the Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).

APPENDIX: Study Organization and Investigators

APPENDIX: Study Organization and Investigators

Writing Committee and Working Group: Montserrat Andreu (Chairman), Virgínia Piñol, Antoni Castells, Artemio Payá, Xavier Bessa, and Rodrigo Jover. Montserrat Andreu and Antoni Castells conceived the idea for the study; Virgínia Piñol, Montserrat Andreu, Antoni Castells, and Artemio Payá designed the protocol; Virgínia Piñol supervised the execution of the study; Virgínia Piñol, Antoni Castells and Montserrat Andreu drafted the report; Virgínia Piñol was responsible for database design and management; Virgínia Piñol, Antoni Castells and Llorenç Quintó did the statistical analysis; Artemio Payá provided histopathological advice.

All participants listed below were fully involved in the study and were given an oppurtunity to comment on the paper:

Fundació Hospital Son Llatzer, Palma de Mallorca: Angels Vilella (local coordinator), Carlos Dolz, Hernan Andreu; Hospital 12 de Octubre, Madrid: Juan Diego Morillas (local coordinator), Raquel Muñoz, Marisa Manzano, Francisco Colina, Jose Díaz, Carolina Ibarrola, Guadalupe López, Alberto Ibáñez; Hospital Clínic, Barcelona: Antoni Castells (local coordinator), Virgínia Piñol, Sergi Castellví-Bel, Maria Pellisé, Antonio Soriano, Francisco Rodríguez-Moranta, Josep Ignasi Elizalde, Rosa Miquel, Llorenç Quintó, Josep M Piqué; Hospital Clínico Universitario, Zaragoza: Angel Lanas (local coordinator), Javier Alcedo, Javier Ortego; Hospital Comarcal de l’Alt Penedès, Vilafranca del Penedès: Mercedes Martínez (local coordinator); Hospital Cristal-Piñor, Complexo hospitalario de Ourense: Joaquin Cubiella (local coordinator), Mª Soledad Díez, Mercedes Salgado, Eloy Sánchez, Mariano Vega; Hospital del Mar, Barcelona: Montserrat Andreu (local coordinator), Xavier Bessa, Agustín Panadés, Asumpta Munné, Felipe Bory, Miguel Nieto, Agustín Seoane; Hospital Donosti (Edificio Aranzazu), San Sebastián: Juan Ignacio Arenas (local coordinator), Isabel Montalvo, Julio Torrado, Angel Cosme; Hospital General d’Alacant: Artemio Payá (local coordinator), Rodrigo Jover, Juan Carlos Penalva, Cristina Alenda; Hospital General de Granollers: Joaquim Rigau (local coordinator), Angel Serrano, Anna Giménez; Hospital General de Vic: Joan Saló (local coordinator), Eduard Batiste-Alentorn, Josefina Autonell, Ramon Barniol; Hospital General Universitario de Guadalajara: Ana María García (local coordinator), Fernando Carballo, Antonio Bienvenido, Eduardo Sanz, Fernando Gonzalez, Jaime Sanchez; Hospital General Universitario de Valencia: Enrique Medina (local coordinator), Jaime Cuquerella, Pilar Canelles, Miguel Martorell, José Angel García, Francisco Quiles, Elisa Orti; Hospital de l’Esperit Sant, Santa Coloma de Gramenet: Cristina Martin (local coordinator), Llúcia Titó, Sergio Ledesma, Miquel Torres; Hospital do Meixoeiro, Vigo: Juan Clofent (local coordinator), Jaime Seoane, Antoni Tardío, Eugenia Sanchez; Hospital San Agustín, Avilés: Jose María Duque (local coordinator), Isabel García, Juan De la Vega, Manuel Crespo; Hospital San Eloy, Baracaldo: Luís Bujanda (local coordinator), Carmen Muñoz, María del Mar Ramírez, Araceli Sánchez; Hospital Universitari Germans Trias i Pujol, Badalona: Xavier Llor (local coordinator), Mercè Rosinach, Anna Roca, Elisenda Pons, Miquel A. Gassull; Hospital Universitari Mutua de Terrassa: Fernando Fernández-Bañares (local coordinator), Josep M. Viver, Antonio Salas, Jorge Espinós, Montserrat Forné, Maria Esteve; Hospital Universitari Arnau de Vilanova, Lleida: Josep M. Reñé (local coordinator), Carmen Piñol, Juan Buenestado, Joan Viñas; Hospital Universitario de Canarias: Enrique Quintero (local coordinator), David Nicolás, Adolfo Parra, Antonio Martín; Hospital Universitario La Fe, Valencia: Lidia Argüello (local coordinator), Vicente Pons, Virginia Pertejo, Teresa Sala; Hospital Universitario Reina Sofía, Córdoba: Antonio Naranjo (local coordinator), María del Valle García, Patricia López, Fernando López, Rosa Ortega, Javier Briceño, Javier Padillo; Hospital Universitario Virgen del Rocío, Sevilla: Carmen Cordero (local coordinator), Carmen Reyes, Francisco José García, Álvaro Giráldez, Fernando Jiménez, Teresa de Zulueta; Institut Universitari Dexeus, Barcelona: María del Carmen Peña (local coordinator), Javier Nebreda, Antonio Juan-Creix, Javier Juan-Creix, Enrique Vidal, Ferran Gomá.

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Piñol, V., Andreu, M., Castells, A. et al. Synchronous Colorectal Neoplasms in Patients With Colorectal Cancer: Predisposing Individual and Familial Factors. Dis Colon Rectum 47, 1192–1200 (2004). https://doi.org/10.1007/s10350-004-0562-7

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  • DOI: https://doi.org/10.1007/s10350-004-0562-7

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