MULTIPLE COLON TUMORS - DIAGNOSIS AND FOLLOW-UP OF 450 PATIENTS WITH COLORECTAL-CARCINOMA

Objective: failure to diagnose synchronous tumors leads to errors in p atient treatment and prognosis. The existence of metachronous tumors r equires strict patient follow-up to ensure early identification of the second tumor, The present study evaluates the results obtained in the application of a structured procedure for the diagnosis and follow-up of multiple colorectal carcinoma. Materials and methods: a structured procedure was used to follow for 5 years a group of 12 patients with multiple colorectal tumors (7 synchronous and 5 metachronous) of a ser ies of 450 colorectal neoplasms. Results: six synchronous tumors were diagnosed preoperatively and one intraoperative, Of the 5 metachronous neoplasms, 4 strictly adhered to the follow-up protocol, as a result of which the second tumor teas detected at an early stage, The remaini ng case involved no follow-up, and the second tumor was diagnosed in a n advanced stage as a result of bowel occlusion, The left colon was pr edominantly involved; polyps were detected in 9 cases, while two patie nts had 3 malignancies detected by histopathological study, Comments: we emphasize the need for a full evaluation of the colon in all patien ts with colorectal carcinoma, In the case of incomplete preoperative e valuation, intraoperative colonoscopy is to be considered; if this is not feasible it should be performed one month after surgery, A structu red followup procedure permits the early detection of these tumors, th ere by improving patient prognosis.