Adenoma recurrences after resection of colorectal carcinoma: Results from the southwest oncology group 9041 calcium - Chemoprevention pilot study

被引:14
作者
Chu, DZJ
Chansky, K
Alberts, DS
Meyskens, FL
Fenoglio-Preiser, CM
Rivkin, SE
Mills, GM
Giguere, JK
Goodman, GE
Abbruzzese, JL
Lippman, SM
机构
[1] City Hope Natl Med Ctr, Duarte, CA 91010 USA
[2] SW Oncol Grp, Ctr Stat, Seattle, WA USA
[3] Univ Arizona, Ctr Canc, Tucson, AZ USA
[4] Univ Calif Irvine, Orange, CA 92668 USA
[5] Univ Cincinnati, Med Ctr, Cincinnati, OH 45267 USA
[6] Puget Sound Oncol Consortium, Seattle, WA USA
[7] Louisiana State Univ Hlth Sci Ctr, Shreveport, LA 71105 USA
[8] Greenville Community Clin Oncol Program, Greenville, SC USA
[9] Univ Texas, MD Anderson Canc Ctr, Houston, TX 77030 USA
关键词
adenoma; colorectal cancer; synchronous adenoma; adenoma recurrence rate;
D O I
10.1245/ASO.2003.03.037
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
引用
收藏
页码:870 / 875
页数:6
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