Department of Surgery Phramongkutklao Hospital, Thailand.
Department of Pathology, Phrmongkutklao College of Medicine, Thailand.
Asian Pac J Cancer Prev. 2023 May 1;24(5):1643-1649. doi: 10.31557/APJCP.2023.24.5.1643.
This study aimed to compare the clinico-pathologic features, recurrence rate and disease-free survival between colorectal cancers (CRCs) with synchronous advanced colorectal neoplasia (SCN) and solitary CRCs to determine the prognostic significance of SCN.
A retrospective review of prospectively collected data of patients with CRCs was conducted in Phramongkutklao Hospital from January 2009 to December 2014. Patients were categorized in 3 groups: 1) solitary CRCs, 2) CRCs with advanced colorectal adenomas (ACAs) but having no another cancer and 3) synchronous colorectal cancers (S-CRCs) with or without ACAs. Patients undergoing curative resection and complete standard adjuvant treatment were recruited to evaluate the prognostic significance of SCN. Clinicopathologic features, recurrence rate and disease-free survival were analyzed to compare among different groups. Result: Among 328 recruited patients, 282 were classified as solitary CRCs (86%), 23 as CRCs with ACAs (7%) and 23 as S-CRCs (7%). Patients with CRCs with SCN (groups 2 and 3) were significantly older than patients with solitary CRCs (p <0.01), and SCN was found more commonly among males (15.2%) than females (12.3%) (p=0.045). In all, 288 patients achieved a curative resection and accomplished complete standard postoperative adjuvant treatment. Of these, the accumulative number of patients experiencing tumor recurrence was 11.8, 21.2, 24.6, 26.4 and 26.7% at the 1-, 3-, 5-, 7- and 10-year surveillance period, respectively. The disease-free survival of the groups with SCN was marginally higher than that of solitary CRCs groups (p=0.72) (solitary CRCs, 120.7±4.4 months; CRCs/ACAs, 127.4±13.9 months and S-CRCs: 126.2±13.6 months).
CRCs with SCN were found at a more advanced age than those with solitary CRCs. SCN was found more often among males than females. After achieving curative resection and complete adjuvant treatment, the recurrence rate and disease-free survival of CRCs with SCN did not significantly differ from those of solitary CRCs.
本研究旨在比较同时性进展期结直肠腺瘤（SCN）和单发结直肠癌（CRC）的临床病理特征、复发率和无病生存率，以确定 SCN 的预后意义。
对 2009 年 1 月至 2014 年 12 月在 Phramongkutklao 医院前瞻性收集的 CRC 患者数据进行回顾性分析。患者分为 3 组：1）单发 CRCs；2）CRC 伴高级结直肠腺瘤（ACAs）但无其他癌症；3）S-CRCs 伴或不伴 ACAs。招募接受根治性切除术和完整标准辅助治疗的患者，以评估 SCN 的预后意义。分析临床病理特征、复发率和无病生存率，以比较不同组之间的差异。结果：在 328 名入组患者中，282 名被归类为单发 CRCs（86%），23 名被归类为 CRC 伴 ACAs（7%），23 名被归类为 S-CRCs（7%）。SCN 患者（第 2 组和第 3 组）明显比单发 CRCs 患者年龄更大（p<0.01），并且 SCN 在男性中比女性中更常见（15.2%对 12.3%）（p=0.045）。共有 288 名患者接受了根治性切除术，并完成了完整标准的术后辅助治疗。在这些患者中，1 年、3 年、5 年、7 年和 10 年随访期间，肿瘤复发的累积患者数分别为 11.8%、21.2%、24.6%、26.4%和 26.7%。SCN 组的无病生存率略高于单发 CRCs 组（p=0.72）（单发 CRCs，120.7±4.4 个月；CRC/ACAs，127.4±13.9 个月和 S-CRCs，126.2±13.6 个月）。结论：与单发 CRCs 相比，SCN 患者年龄更大。SCN 在男性中比女性中更常见。在获得根治性切除和完整辅助治疗后，SCN 的复发率和无病生存率与单发 CRCs 无显著差异。
