Cerdán J, Torres-Melero J, Diez M, Balsa T, Balibrea J L
II Cátedra de Cirugía, Hospital Universitario, San Carlos, Madrid.
Rev Esp Enferm Dig. 1996 Oct;88(10):655-9.
The metachronous colorectal carcinoma is defined as a primary carcinoma which arises after surgical removal of a previous carcinoma of the large bowel. The incidence of metachronous colorectal cancer has been reported to be 1-8 per cent.
The purpose of the present study was to determine the incidence of metachronous colorectal carcinoma and, on this basis, to propose a follow-up programme after primary resection for cure in this patient group of patients.
Twenty-eight patients with metachronous colorectal malignancies underwent surgery, 16 (57.1%) male and 12 (42.9%) female. These metachronous cancers were discovered at intervals ranging from eight months to seven years (range 28 +/- 10 months). Nine (32%) metachronous lesions were detected two years of more after the original cancer. Six of the metachronous cancers appeared in the right colon, eight were distributed throughout the transverse and descending colon, and fourteen in the rectosigmoid region. Histological examination revealed a high proportion of early stage lesions (82.1% Duke's A more B).
A set of patients surviving their initial colorectal cancer should be followed for the rest of their life because of the risk of developing a second primary. In the light of our experience, a full examination of the colon in these patients is mandatory, and colonoscopy is the best diagnostic procedure.
异时性结直肠癌被定义为在先前大肠恶性肿瘤手术切除后发生的原发性癌。据报道，异时性结直肠癌的发病率为1%至8%。
本研究的目的是确定异时性结直肠癌的发病率，并在此基础上为该患者群体提出根治性初次切除术后的随访方案。
28例异时性结直肠恶性肿瘤患者接受了手术，其中男性16例（57.1%），女性12例（42.9%）。这些异时性癌症的发现间隔时间为8个月至7年（平均28±10个月）。9例（32%）异时性病变在原发癌发生两年或更长时间后被检测到。6例异时性癌症出现在右半结肠，8例分布在整个横结肠和降结肠，14例在直肠乙状结肠区域。组织学检查显示早期病变比例较高（82.1%为杜克A期或B期）。
由于存在发生第二原发性癌的风险，一组初次结直肠癌存活患者应终生接受随访。根据我们的经验，对这些患者进行全结肠检查是必要的，而结肠镜检查是最佳的诊断方法。
