METACHRONOUS COLORECTAL-CARCINOMA

Introduction: The metachronous colorectal carcinoma is defined as a pr imary carcinoma which arises after surgical removal of a previous carc inoma of the large bowel, The incidence of metachronous colorectal can cer has been reported to be 1-8 per cent. The aim: The purpose of the present study was to determine the incidence of metachronous colorecta l carcinoma and, on this basis, to propose a follow-up programme after primary resection for cure in this patient group of patients. Patient s and methods: Twenty-eight patients with metachronous colorectal mali gnancies underwent surgery, 16 (57.1%) male and 12 (42.9%) female. The se metachronous cancers were discovered at intervals ranging from eigh t months to seven years (range 28+/-10 months). Nine (32%) metachronou s lesions were detected two years of more after the original cancer. S ix of the metachronous cancers appeared in the right colon, eight were distributed throughout the transverse and descending colon, and fourt een in the rectosigmoid region, Histological examination revealed a hi gh proportion of early stage lesions (82.1% Duke's A more B). Conclusi on: A set of patients surviving their initial colorectal cancer should be followed for the rest of their life because of the risk of develop ing a second primary, In the light of our experience, a full examinati on of the colon in these patients is mandatory, and colonoscopy is the best diagnostic procedure.