BACKGROUND: Up to 9 per cent of patients who undergo resection for colorectal cancer develop metachronous cancers. There is no consensus on the detection and management of such cancers. METHODS: The literature was reviewed exhaustively regarding the incidence, clinical characteristics, detection, treatment and molecular genetics of metachronous colorectal cancers. This was based on a Medline search from 1966 to December 1997 for articles on metachronous colorectal cancers. A manual search was also performed on references quoted in these articles. All publications relevant to this study were included. RESULTS: Although the underlying causes for metachronous colorectal cancers are yet to be elucidated, risk factors for the disease have been identified. These include the presence of synchronous polyps or cancers, a history of metachronous cancers, and hereditary non-polyposis colorectal cancer (HNPCC). CONCLUSION: Preoperative colonoscopy and postoperative colonoscopic surveillance are essential in identifying patients at risk of metachronous colorectal cancer. A total colectomy and ileorectal anastomosis should be considered for some patients, certainly for those with HNPCC.
BACKGROUND: Up to 9 per cent of patients who undergo resection for colorectal cancer develop metachronous cancers. There is no consensus on the detection and management of such cancers. METHODS: The literature was reviewed exhaustively regarding the incidence, clinical characteristics, detection, treatment and molecular genetics of metachronous colorectal cancers. This was based on a Medline search from 1966 to December 1997 for articles on metachronous colorectal cancers. A manual search was also performed on references quoted in these articles. All publications relevant to this study were included. RESULTS: Although the underlying causes for metachronous colorectal cancers are yet to be elucidated, risk factors for the disease have been identified. These include the presence of synchronous polyps or cancers, a history of metachronous cancers, and hereditary non-polyposis colorectal cancer (HNPCC). CONCLUSION: Preoperative colonoscopy and postoperative colonoscopic surveillance are essential in identifying patients at risk of metachronous colorectal cancer. A total colectomy and ileorectal anastomosis should be considered for some patients, certainly for those with HNPCC.
Authors: Harindra Jayasekara; Jeanette C Reece; Daniel D Buchanan; Christophe Rosty; S Ghazaleh Dashti; Driss Ait Ouakrim; Ingrid M Winship; Finlay A Macrae; Alex Boussioutas; Graham G Giles; Dennis J Ahnen; Jan Lowery; Graham Casey; Robert W Haile; Steven Gallinger; Loic Le Marchand; Polly A Newcomb; Noralane M Lindor; John L Hopper; Susan Parry; Mark A Jenkins; Aung Ko Win Journal: Int J Cancer Date: 2016-05-09 Impact factor: 7.316