دورية أكاديمية
Metachronous colorectal cancers result from missed lesions and non-compliance with surveillance.
العنوان: | Metachronous colorectal cancers result from missed lesions and non-compliance with surveillance. |
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المؤلفون: | le Clercq CM; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands; GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands., Winkens B; Department of Methodology and Statistics, Maastricht University Medical Center, Maastricht, The Netherlands; CAPHRI, School for Public Health and Primary Care, Maastricht University Medical Center, Maastricht, The Netherlands., Bakker CM; Department of Internal Medicine and Gastroenterology, Atrium Medical Center Heerlen, Heerlen, The Netherlands., Keulen ET; Department of Internal Medicine and Gastroenterology, Orbis Medical Center Sittard, Sittard, The Netherlands., Beets GL; GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., Masclee AA; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands; NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands., Sanduleanu S; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands; GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands. |
المصدر: | Gastrointestinal endoscopy [Gastrointest Endosc] 2015 Aug; Vol. 82 (2), pp. 325-333.e2. Date of Electronic Publication: 2015 Apr 02. |
نوع المنشور: | Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: Mosby Yearbook Country of Publication: United States NLM ID: 0010505 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6779 (Electronic) Linking ISSN: 00165107 NLM ISO Abbreviation: Gastrointest Endosc Subsets: MEDLINE |
أسماء مطبوعة: | Publication: St Louis, Mo : Mosby Yearbook Original Publication: Denver. |
مواضيع طبية MeSH: | Population Surveillance*, Adenocarcinoma/*diagnosis , Adenoma/*diagnosis , Colorectal Neoplasms/*diagnosis , Diagnostic Errors/*statistics & numerical data , Neoplasms, Second Primary/*diagnosis , Patient Compliance/*statistics & numerical data, Adenocarcinoma/etiology ; Adenocarcinoma/pathology ; Adenoma/surgery ; Aged ; Aged, 80 and over ; Algorithms ; Colonoscopy/standards ; Colorectal Neoplasms/surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm, Residual ; Neoplasms, Second Primary/etiology ; Neoplasms, Second Primary/pathology ; Retrospective Studies |
مستخلص: | Background: Several studies examined the rate of colorectal cancer (CRC) developed during colonoscopy surveillance after CRC resection (ie, metachronous CRC [mCRC]), yet the underlying etiology is unclear. Objective: To examine the rate and likely etiology of mCRCs. Design: Population-based, multicenter study. Review of clinical and histopathologic records, including data of the national pathology database and The Netherlands Cancer Registry. Setting: National cancer databases reviewed at 3 hospitals in South-Limburg, The Netherlands. Patients: Total CRC population diagnosed in South-Limburg from January 2001 to December 2010. Interventions: Colonoscopy. Main Outcome Measurements: We defined an mCRC as a second primary CRC, diagnosed >6 months after the primary CRC. By using a modified algorithm to ascribe likely etiology, we classified the mCRCs into cancers caused by non-compliance with surveillance recommendations, inadequate examination, incomplete resection of precursor lesions (CRC in same segment as previous advanced adenoma), missed lesions, or newly developed cancers. Results: We included a total of 5157 patients with CRC, of whom 93 (1.8%) had mCRCs, which were diagnosed on an average of 81 months (range 7-356 months) after the initial CRC diagnosis. Of all mCRCs, 43.0% were attributable to non-compliance with surveillance advice, 43.0% to missed lesions, 5.4% to incompletely resected lesions, 5.4% to newly developed cancers, and 3.2% to inadequate examination. Age-adjusted and sex-adjusted logistic regression analyses showed that mCRCs were significantly smaller in size (odds ratio [OR] 0.8; 95% confidence interval [CI], 0.7-0.9) and more often poorly differentiated (OR 1.7; 95% CI, 1.0-2.8) than were solitary CRCs. Limitations: Retrospective evaluation of clinical data. Conclusion: In this study, 1.8% of all patients with CRC developed mCRCs, and the vast majority were attributable to missed lesions or non-compliance with surveillance advice. Our findings underscore the importance of high-quality colonoscopy to maximize the benefit of post-CRC surveillance. (Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.) |
التعليقات: | Comment in: Gastrointest Endosc. 2015 Aug;82(2):334-6. (PMID: 26183494) |
تواريخ الأحداث: | Date Created: 20150407 Date Completed: 20160414 Latest Revision: 20220321 |
رمز التحديث: | 20221213 |
DOI: | 10.1016/j.gie.2014.12.052 |
PMID: | 25843613 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1097-6779 |
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DOI: | 10.1016/j.gie.2014.12.052 |