Clinical characteristics of synchronous colorectal cancers in Japan.
Clinical characteristics of synchronous colorectal cancers in Japan.
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日本同步结直肠癌的临床特征。
DOI：
10.1186/s12957-016-1027-x
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发表时间：
2016-10-24
影响因子：
3.2
通讯作者：
Rikiyama T
中科院分区：
文献类型：
--
作者：
Kato T;Alonso S;Muto Y;Noda H;Miyakura Y;Suzuki K;Tsujinaka S;Saito M;Perucho M;Rikiyama T
同步性结直肠癌（sCRC）患者的发病率和临床特征在研究中存在显著差异，可能是由于监测方法的差异。如果未被发现，sCRC可能进展到更晚期，严重恶化患者预后。我们研究了日本sCRC患者的发病率和临床病理学特征，这些患者接受了原发性CRC手术并接受了详尽的围手术期监测。我们在2007年1月至2011年12月期间招募了1005例手术切除的CRC患者。通过单因素和多因素Logistic回归分析，评估临床和病理因素与sCRC发展的相关性。84例患者（8.4%）发生sCRC，其中16例（19.0%）患有三种或三种以上癌症。伴发的sCRCs比索引病变小且分期早（P < 0.0001）。在多变量分析中，高龄（比值比（OR）1.03/年; P = 0.009）和左结肠肿瘤位置（OR 1.78; P = 0.013）与sCRC风险较高相关，尤其是女性。孤立性CRC和sCRC的总生存率没有差异（P = 0.62）。我们的研究结果强调了围手术期结肠镜检查的重要性，以确保没有sCRC，因为小和早期阶段，更难以检测。sCRC的发生率，特别是三重或三重以上sCRC的发生率，高于先前的认识。因为它们也明显高于预期的仅仅是随机积累的个别癌性病变，我们认为，许多sCRC的发生反映了迄今为止未表征的易感性条件。本文的在线版本（doi：10.1186/s12957-016-1027-x）包含补充材料，可供授权用户使用。
Incidence and clinical characteristics of synchronous colorectal cancer (sCRC) patients significantly vary among studies, likely due to differences in surveillance methodology. If remain undetected, sCRC can progress to more advanced stages seriously aggravating patient prognosis. We studied the incidence and clinicopathological characteristics of Japanese patients with sCRCs who underwent surgery for primary CRC and received exhaustive perioperative surveillance. We recruited 1005 patients with surgically resected CRCs between January 2007 and December 2011. The associations of clinical and pathological factors with sCRC development were assessed by univariate and multivariate logistic regression. Eighty-four patients (8.4 %) developed sCRCs, 16 of them (19.0 %) harboring three or more cancers. Companion sCRCs were smaller and earlier stage than the index lesion (P < 0.0001). In multivariate analysis, advanced age (odds ratio (OR) 1.03 per year; P = 0.009) and left colon tumor location (OR 1.78; P = 0.013) are associated with higher risk of sCRCs, particularly in females. Overall survival did not differ between solitary CRC and sCRC (P = 0.62). Our results highlight the importance of perioperative colonoscopy examination to ensure the absence of sCRCs that, being small and early staged, are more difficult to detect. The incidence of sCRC, and notably of triple or more sCRCs, was higher than previously recognized. Because they are also significantly higher than expected by merely stochastic accumulation of individual cancerous lesions, we suggest that the occurrence of many sCRC reflects a hitherto uncharacterized predisposition condition. The online version of this article (doi:10.1186/s12957-016-1027-x) contains supplementary material, which is available to authorized users.
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影响因子：
158.5
作者：
Hampel, H;Frankel, WL;Papadopoulos, N
通讯作者：
Papadopoulos, N
影响因子：
3.9
作者：
Chen, HS;Sheen-Chen, SM
通讯作者：
Sheen-Chen, SM
影响因子：
2.6
作者：
Mulder, Sanna A.;Kranse, Ries;van Leerdam, Monique E.
通讯作者：
van Leerdam, Monique E.
影响因子：
3.3
作者：
Papadopoulos, V;Michalopoulos, A;Harlaftis, N
通讯作者：
Harlaftis, N
影响因子：
3.9
作者：
Bae, Jeong M.;Cho, Nam-Yun;Kang, Gyeong H.
通讯作者：
Kang, Gyeong H.