Skip to main content

Advertisement

SpringerLink
Log in

Metachronous carcinomas in colorectum and its clinicopathological significance

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The study was designed to examine the significance of colorectal metachronous carcinoma in a large cohort of patients.

Methods

Over a mean follow-up period of 10 years, the clinicopathological features, microsatellite instability (MSI) and clinical follow-up of 56 patients with metachronous colorectal carcinoma were analysed.

Results

The prevalence of metachronous colorectal carcinoma was 2.1 %. The metachronous colorectal carcinomas appeared between 7 and 246 months (mean = 66 months) after surgical resection of the index colorectal carcinomas. Thirty-six per cent (n = 20) of the metachronous carcinoma occurred more than 5 years after the operation of the index carcinoma. Of the 56 patients, 20 % (n = 11) of the metachronous colorectal carcinomas were mucinous adenocarcinoma. Cancers detected in the secondary operations (metachronous colorectal carcinomas), when compared with the primary index cancers, were smaller, showed higher proportions of mucinous adenocarcinoma and more often located in the proximal colon. Patients with metachronous colorectal cancers had higher prevalence of mucinous adenocarcinoma, loss of staining for MSI markers and better survival rates than other patients with colorectal cancers.

Conclusions

Patients with metachronous colorectal carcinomas have characteristic features, and attention to these features is important for better management of this group of cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bekdash B, Harris S, Broughton CI, Caffarey SM, Marks CG (1997) Outcome after multiple colorectal tumours. Br J Surg 84(10):1442–1444

    Article  PubMed  CAS  Google Scholar 

  2. Chen HS, Sheen-Chen SM (2000) Synchronous and “early” metachronous colorectal adenocarcinoma: analysis of prognosis and current trends. Dis Colon Rectum 43(8):1093–1099

    Article  PubMed  CAS  Google Scholar 

  3. Wang HZ, Huang XF, Wang Y, Ji JF, Gu J (2004) Clinical features, diagnosis, treatment and prognosis of multiple primary colorectal carcinoma. World J Gastroenterol 10(14):2136–2139

    PubMed  Google Scholar 

  4. Velayos FS, Lee SH, Qiu H, Dykes S, Yiu R, Terdiman JP, Garcia-Aguilar J (2005) The mechanism of microsatellite instability is different in synchronous and metachronous colorectal cancer. J Gastrointest Surg 9(3):329–335

    Article  PubMed  Google Scholar 

  5. Lan YT, Lin JK, Li AF, Lin TC, Chen WS, Jiang JK, Yang SH, Wang HS, Chang SC (2005) Metachronous colorectal cancer: necessity of post-operative colonoscopic surveillance. Int J Colorectal Dis 20(2):121–125

    Article  PubMed  Google Scholar 

  6. Park IJ, Yu CS, Kim HC, Jung YH, Han KR, Kim JC (2006) Metachronous colorectal cancer. Colorectal Dis 8(4):323–327

    Article  PubMed  CAS  Google Scholar 

  7. Ballesté B, Bessa X, Piñol V, Castellví-Bel S, Castells A, Alenda C, Paya A, Jover R, Xicola RM, Pons E, Llor X, Cordero C, Fernandez-Bañares F, de Castro L, Reñé JM, Andreu M, Gastrointestinal Oncology Group of the Spanish Gastroenterological Association (2007) Detection of metachronous neoplasms in colorectal cancer patients: identification of risk factors. Dis Colon Rectum 50(7):971–980

    Article  PubMed  Google Scholar 

  8. Yoon JW, Lee SH, Ahn BK, Baek SU (2008) Clinical characteristics of multiple primary colorectal cancers. Cancer Res Treat 40(2):71–74

    Article  PubMed  Google Scholar 

  9. Tziris N, Dokmetzioglou J, Giannoulis K, Kesisoglou I, Sapalidis K, Kotidis E, Gambros O (2008) Synchronous and metachronous adenocarcinomas of the large intestine. Hippokratia 12(3):150–152

    PubMed  CAS  Google Scholar 

  10. Hollington P, Tiong L, Young G (2011) Timing and detection of metachronous colorectal cancer. ANZ J Surg 81(4):272–274

    Article  PubMed  Google Scholar 

  11. Hamilton SR, Vogelstein B, Kudo S, Riboli E, Nakamura S, Hainaut P (2000) In: Hamilton SR, Aaltonen LA (eds) Carcinoma of the colon and rectum. WHO classification of tumors: pathology and genetics of tumors of digestive system. IARC Press, Lyon, pp 105–119

    Google Scholar 

  12. Umar A, Boland CR, Terdiman JP, Syngal S, de la Chapelle A, Rüschoff J, Fishel R, Lindor NM, Burgart LJ, Hamelin R, Hamilton SR, Hiatt RA, Jass J, Lindblom A, Lynch HT, Peltomaki P, Ramsey SD, Rodriguez-Bigas MA, Vasen HF, Hawk ET, Barrett JC, Freedman AN, Srivastava S (2004) Revised Bethesda Guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. J Natl Cancer Inst 96(4):261–268

    Article  PubMed  CAS  Google Scholar 

  13. Pritchard CC, Grady WM (2011) Colorectal cancer molecular biology moves into clinical practice. Gut 60(1):116–129

    Article  PubMed  CAS  Google Scholar 

  14. Geiersbach KB, Samowitz WS (2011) Microsatellite instability and colorectal cancer. Arch Pathol Lab Med 135(10):1269–1277

    Article  PubMed  CAS  Google Scholar 

  15. Lam AK, Carmichael R, Gertraud Buettner P, Gopalan V, Ho YH, Siu S (2011) Clinicopathological significance of synchronous carcinoma in colorectal cancer. Am J Surg 202(1):39–44

    Article  PubMed  Google Scholar 

  16. Lam AKY, Ong K, Ho YH (2006) Colorectal mucinous adenocarcinoma: the clinicopathologic features and significance of p16 and p53 Expression. Dis Colon Rectum 49(9):175–183

    Google Scholar 

  17. Gopalan V, Smith RA, Ho YH, Lam AK (2011) Signet-ring cell carcinoma of colorectum—current perspectives and molecular biology. Int J Colorectal Dis 26(2):127–133

    Article  PubMed  Google Scholar 

  18. Leopoldo S, Lorena B, Cinzia A, Gabriella DC, Angela Luciana B, Renato C, Antonio M, Carlo S, Cristina P, Stefano C, Maurizio T, Luigi R, Cesare B (2008) Two subtypes of mucinous adenocarcinoma of the colorectum: clinicopathological andgenetic features. Ann Surg Oncol 15(5):1429–39

    Article  PubMed  Google Scholar 

  19. Gopalan V, Smith RA, Nassiri MR, Yasuda K, Salajegheh A, Kim SY, Ho YH, Weinstein S, Tang JC, Lam AK (2010) GAEC1 and colorectal cancer: a study of the relationships between a novel oncogene and clinicopathologic features. Hum Pathol 41(7):1009–1015

    Article  PubMed  CAS  Google Scholar 

  20. Lam AK, Ong K, Ho YH (2008) Aurora kinase expression in colorectal adenocarcinoma: correlations with clinicopathological features, p16 expression, and telomerase activity. Hum Pathol 39(4):599–604

    Article  PubMed  CAS  Google Scholar 

  21. Saleh S, Lam AK, Ho YH (2008) Real-time PCR quantification of human telomerase reverse transcriptase (hTERT) in colorectal cancer. Pathology 40(1):25–30

    Article  PubMed  CAS  Google Scholar 

  22. Bülow S, Svendsen LB, Mellemgaard A (1990) Metachronous colorectal carcinoma. Br J Surg 77(5):502–505

    Article  PubMed  Google Scholar 

  23. Sargent DJ, Marsoni S, Monges G, Thibodeau SN, Labianca R, Hamilton SR, French AJ, Kabat B, Foster NR, Torri V, Ribic C, Grothey A, Moore M, Zaniboni A, Seitz JF, Sinicrope F, Gallinger S (2010) Defective mismatch repair as a predictive marker for lack of efficacy of fluorouracil-based adjuvant therapy in colon cancer. J Clin Oncol 28(20):3219–3226

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cancer Molecular Pathology, School of Medicine and Griffith Health Institute, Griffith University, Gold Coast, QLD, 4222, Australia

    Alfred King-Yin Lam, Vinod Gopalan, Melissa Leung & Robert Smith

  2. Divsion of Colorectal Surgery, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia

    Robert Carmichael

  3. Division of Surgery (School of Medicine) and North Queensland Centre for Cancer Research (Australian Institute of Tropical Medicine), James Cook University, Townsville, QLD, Australia

    Petra Gertraud Buettner & Yik-Hong Ho

  4. Department of Surgery, Gold Coast Hospital, Gold Coast, QLD, Australia

    Cu-Tai Lu

  5. Griffith Medical School, Griffith University Gold Coast Campus, Gold Coast, QLD, 4222, Australia

    Alfred King-Yin Lam & Simon Siu

Authors
  1. Alfred King-Yin Lam
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vinod Gopalan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert Carmichael
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Petra Gertraud Buettner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Melissa Leung
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Robert Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Cu-Tai Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yik-Hong Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Simon Siu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alfred King-Yin Lam.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lam, A.KY., Gopalan, V., Carmichael, R. et al. Metachronous carcinomas in colorectum and its clinicopathological significance. Int J Colorectal Dis 27, 1303–1310 (2012). https://doi.org/10.1007/s00384-012-1474-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-012-1474-y

Keywords

Search

Navigation