Co-localization of colon carcinomas and adenomas

Abstract:

Purpose: Finding common genetic alterations in colorectal cancers and peri-tumoral mucosa first led to the notion of colonic field defects. The hypothesis of a genetically determined mosaicism would explain this defects and would make the co-localization of tumors likely. Our purpose was to indirectly test this hypothesis by searching for a possible correlation between the location of colorectal cancers and adenomas. Methods: Retrospective observational study. Patients operated for colorectal cancers at an oncological hospital, who had a total colonoscopy performed in the two peri-operative years were surveyed. Sex, age, familial risk of cancer, tumor and adenomas' locations, and the presence of adenomas larger than 1cm, with villous component or high grade dysplasia were recorded. Statistics: T test, Chi-square, Exact, Logistic regression (SPSS18®). Results: 244 patients included (57% male, mean age 67,6 years), 45% of which had synchronous adenomas. There was a significant correlation between cancer location and location of all adenomas (p=0,01) and of adenomas larger than 1cm (p=0,01). Adenomas of the right colon were more frequent in patients with right colon cancer (p=0,008), and the same was true on the left colon (p=0,002). Conclusions: The strong correlation between the locations of CRC and synchronous adenomas, namely risk adenomas, may point to a common early defect. It does also suggest hemicolectomy may always be the surgery of choice for colon cancer.

Journal: International Journal of Colorectal Diseases