Adenoma recurrences after resection of colorectal carcinoma: Results from the southwest oncology group 9041 calcium - Chemoprevention pilot study
Adenoma recurrences after resection of colorectal carcinoma: Results from the southwest oncology group 9041 calcium - Chemoprevention pilot study
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DOI：
10.1245/aso.2003.03.037
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发表时间：
2003-10-01
影响因子：
3.7
通讯作者：
Lippman, SM
中科院分区：
文献类型：
--
作者：
Chu, DZJ;Chansky, K;Lippman, SM
背景：结直肠腺瘤是散发性和遗传性结直肠癌（CRC）的常见前体。方法：在一项以复发性结直肠腺瘤为替代终点的钙化学预防的双盲先导研究中，共有220名CRC患者（0期，I期和II期）被随机分组。这项试验仍在进行中，我们报告腺瘤复发率的初步结果。结果：60%的患者存在同步腺瘤，23%的患者存在局限于息肉的癌症。总的累积腺瘤复发率为31%（第一年19%，2年29%，3年35%）。同时性腺瘤患者的复发率更高：3年复发率为38% （P = 0.01）。分期越低，腺瘤复发率越高（P = 0.04）。年龄、性别、原发癌部位、肿瘤是否局限于息肉等因素与腺瘤复发率差异无显著相关。结论：结直肠癌切除术患者的腺瘤复发率高，值得定期进行结肠镜检查。腺瘤复发率较高的患者，如伴有同步腺瘤的结直肠癌，是化学预防试验的理想对象。
Background: Colorectal adenomas are the usual precursors to carcinoma in sporadic and hereditary colorectal cancers (CRC).Methods: A total of 220 CRC patients (stages 0, I, and II) were randomized prospectively in a double-blind pilot study of calcium chemoprevention by using recurrent colorectal adenomas as a surrogate end point. This trial is still in progress, and we report the preliminary findings on adenoma recurrence rates.Results: Synchronous adenomas were present in 60% of patients, and cancer confined in a polyp was present in 23% of patients. The overall cumulative adenoma recurrence rate was 31% (19% in the first year, 29% for 2 years, and 35% for 3 years). The recurrence rates were greater for patients with synchronous adenomas: 38% at 3 years (P = .01). Lower stage was associated with higher adenoma recurrence rates (P = .04). Factors including age, sex, site of primary cancer, and whether the cancer was confined to a polyp were not significantly associated with differences in adenoma recurrence rates.Conclusions: The substantial adenoma recurrence rate in patients resected of CRC justifies colonoscopic surveillance on a periodic basis. Patients with higher rates of adenoma recurrences, such as CRC with synchronous adenomas, are ideal subjects for chemoprevention trials.