Utilitá di un follow-up endoscopico nei pazienti resecati per cancro del colon retto

Translated title of the contribution: Utility of endoscopic follow-up after radical surgery for colorectal cancer

V. Stigliano, P. Fracasso, A. Grassi, R. Lapenta, F. Citarda, G. Tomaselli, D. Giannarelli, V. Casale

Research output: Contribution to journalArticle

Abstract

Purpose: Patients resected for colorectal cancer are at incresed risk for an anastomotic recurrence, for adenomatous polyps and for a metachronous cancer. A regular colonoscopic surveillance in these patients is justified for early detection and potential resection of anastomotic recurrences, new primary cancer and adenomatous polyps. Patients and Methods: 322 patients were observed and resected for colorectal cancer between 1970 and 1988, with complete staging agreed to be included in a follow-up program (median follow-up: 105 months). To December 1993 all the patients were submitted to colonoscopy once yearly for the first 5 years and then every 2 years. Results: Anastomotic recurrence was observed in 22 of the 253 patients who underwent resection for rectal or sigmoid adenocarcinoma (8.7%). Sixteen of these patients were submitted to a second curative resection with a median survival of 35 months; the median survival was 6 months in the 6 patients who could not undergo this operation (p=0.0018). Metachronous adenomas of the residual colon were found in 24 patients (7,4%) and metachronous cancers in 5 (1,5%) at Stage A, according to Dukes' classification. Conclusions: In patients resected for rectal or sigmoid carcinoma, a sigmoidoscopy should be performed every 6 months for the first 2 years for the early detection of anastomotic recurrences. In all cases, a colonoscopy should be performed every 5 years after surgery to detect metachronous lesions at early stage. Before surgery, a "clean colon" should always be established to detect possible synchronous lesions.

Original languageItalian
Pages (from-to)323-326
Number of pages4
JournalClinica Terapeutica
Volume153
Issue number5
Publication statusPublished - Sep 2002

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Colorectal Neoplasms
Adenomatous Polyps
Recurrence
Sigmoid Colon
Colonoscopy
Colon
Sigmoidoscopy
Neoplasms
Survival
Adenoma
Adenocarcinoma
Carcinoma

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Stigliano, V., Fracasso, P., Grassi, A., Lapenta, R., Citarda, F., Tomaselli, G., ... Casale, V. (2002). Utilitá di un follow-up endoscopico nei pazienti resecati per cancro del colon retto. Clinica Terapeutica, 153(5), 323-326.

Utilitá di un follow-up endoscopico nei pazienti resecati per cancro del colon retto. / Stigliano, V.; Fracasso, P.; Grassi, A.; Lapenta, R.; Citarda, F.; Tomaselli, G.; Giannarelli, D.; Casale, V.

In: Clinica Terapeutica, Vol. 153, No. 5, 09.2002, p. 323-326.

Research output: Contribution to journalArticle

Stigliano, V, Fracasso, P, Grassi, A, Lapenta, R, Citarda, F, Tomaselli, G, Giannarelli, D & Casale, V 2002, 'Utilitá di un follow-up endoscopico nei pazienti resecati per cancro del colon retto', Clinica Terapeutica, vol. 153, no. 5, pp. 323-326.
Stigliano V, Fracasso P, Grassi A, Lapenta R, Citarda F, Tomaselli G et al. Utilitá di un follow-up endoscopico nei pazienti resecati per cancro del colon retto. Clinica Terapeutica. 2002 Sep;153(5):323-326.
Stigliano, V. ; Fracasso, P. ; Grassi, A. ; Lapenta, R. ; Citarda, F. ; Tomaselli, G. ; Giannarelli, D. ; Casale, V. / Utilitá di un follow-up endoscopico nei pazienti resecati per cancro del colon retto. In: Clinica Terapeutica. 2002 ; Vol. 153, No. 5. pp. 323-326.
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AU - Lapenta, R.

AU - Citarda, F.

AU - Tomaselli, G.

AU - Giannarelli, D.

AU - Casale, V.

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N2 - Purpose: Patients resected for colorectal cancer are at incresed risk for an anastomotic recurrence, for adenomatous polyps and for a metachronous cancer. A regular colonoscopic surveillance in these patients is justified for early detection and potential resection of anastomotic recurrences, new primary cancer and adenomatous polyps. Patients and Methods: 322 patients were observed and resected for colorectal cancer between 1970 and 1988, with complete staging agreed to be included in a follow-up program (median follow-up: 105 months). To December 1993 all the patients were submitted to colonoscopy once yearly for the first 5 years and then every 2 years. Results: Anastomotic recurrence was observed in 22 of the 253 patients who underwent resection for rectal or sigmoid adenocarcinoma (8.7%). Sixteen of these patients were submitted to a second curative resection with a median survival of 35 months; the median survival was 6 months in the 6 patients who could not undergo this operation (p=0.0018). Metachronous adenomas of the residual colon were found in 24 patients (7,4%) and metachronous cancers in 5 (1,5%) at Stage A, according to Dukes' classification. Conclusions: In patients resected for rectal or sigmoid carcinoma, a sigmoidoscopy should be performed every 6 months for the first 2 years for the early detection of anastomotic recurrences. In all cases, a colonoscopy should be performed every 5 years after surgery to detect metachronous lesions at early stage. Before surgery, a "clean colon" should always be established to detect possible synchronous lesions.

AB - Purpose: Patients resected for colorectal cancer are at incresed risk for an anastomotic recurrence, for adenomatous polyps and for a metachronous cancer. A regular colonoscopic surveillance in these patients is justified for early detection and potential resection of anastomotic recurrences, new primary cancer and adenomatous polyps. Patients and Methods: 322 patients were observed and resected for colorectal cancer between 1970 and 1988, with complete staging agreed to be included in a follow-up program (median follow-up: 105 months). To December 1993 all the patients were submitted to colonoscopy once yearly for the first 5 years and then every 2 years. Results: Anastomotic recurrence was observed in 22 of the 253 patients who underwent resection for rectal or sigmoid adenocarcinoma (8.7%). Sixteen of these patients were submitted to a second curative resection with a median survival of 35 months; the median survival was 6 months in the 6 patients who could not undergo this operation (p=0.0018). Metachronous adenomas of the residual colon were found in 24 patients (7,4%) and metachronous cancers in 5 (1,5%) at Stage A, according to Dukes' classification. Conclusions: In patients resected for rectal or sigmoid carcinoma, a sigmoidoscopy should be performed every 6 months for the first 2 years for the early detection of anastomotic recurrences. In all cases, a colonoscopy should be performed every 5 years after surgery to detect metachronous lesions at early stage. Before surgery, a "clean colon" should always be established to detect possible synchronous lesions.

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