Kim Sung Bae, Lee Hyun Jung, Park Soo Jung, Hong Sung Pil, Cheon Jae Hee, Kim Won Ho, Kim Tae Il
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
J Cancer Prev. 2017 Sep;22(3):159-165. doi: 10.15430/JCP.2017.22.3.159. Epub 2017 Sep 30.
Young-onset colorectal cancer is uncommon, but the incidence is increasing. Despite several guidelines for colonoscopic surveillance following colorectal cancer resection, there is little consistency regarding the timing and age-adjusted strategies of surveillance colonoscopy after surgery of young-onset colorectal cancer. The aim of this study was to compare the outcomes of surveillance colonoscopy between sporadic colorectal cancer patients with young and older age after curative resection.
We retrospectively reviewed 569 colorectal cancer patients who underwent curative resection between January 2006 and December 2010. The primary outcome was comparison of the development of metachronous advanced neoplasia during surveillance colonoscopy between young and older colorectal cancer patients.
There were 95 patients in the young age group and 474 patients in the older age group. The mean time interval from surgery to the development of metachronous advanced neoplasia was 99.2 ± 3.7 months in the young age group and 84.4 ± 2.5 months in the old age group ( = 0.03). In the multivariate analysis, age (OR, 3.56; = 0.04) and family history of colorectal cancer (OR, 2.66; = 0.008) were associated with the development of metachronous advanced neoplasia. None of the young patients without both family history of colorectal cancer and high-risk findings at index colonoscopy showed advanced neoplasia during the follow-up period.
Age and family history of colorectal cancer are independent risk factors for the occurrence of advanced neoplasia after curative colorectal cancer resection, suggesting age-adjusted strategies of surveillance colonoscopy.
青年期结直肠癌并不常见，但发病率正在上升。尽管有多项关于结直肠癌切除术后结肠镜监测的指南，但对于青年期结直肠癌术后监测结肠镜检查的时间和年龄调整策略，几乎没有一致性。本研究的目的是比较散发性结直肠癌患者在根治性切除术后青年组和老年组的结肠镜监测结果。
我们回顾性分析了2006年1月至2010年12月期间接受根治性切除的569例结直肠癌患者。主要结局是比较青年和老年结直肠癌患者在结肠镜监测期间异时性进展性腺瘤的发生情况。
青年组有95例患者，老年组有474例患者。青年组从手术到异时性进展性腺瘤发生的平均时间间隔为99.2±3.7个月，老年组为84.4±2.5个月（P=0.03）。在多变量分析中，年龄（OR，3.56；P=0.04）和结直肠癌家族史（OR，2.66；P=0.008）与异时性进展性腺瘤的发生相关。在结肠镜检查时既无结直肠癌家族史也无高危发现的青年患者在随访期间均未出现进展性腺瘤。
年龄和结直肠癌家族史是结直肠癌根治性切除术后发生进展性腺瘤的独立危险因素，提示应采用年龄调整的结肠镜监测策略。
