Second primary cancer after surgery for colorectal cancer without lymph node metastasis
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Updated: May 2, 2026
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
Yoichi Ikeda1, Fumiaki Kishihara, Hideki Saitsu
1Department of Surgery, Clinical Research Institute, National Kyushu Medical Center, Chuo-ku, Fukuoka, 810-8563 Japan. yoikeda@qmed.hosp.go.jp
Background/Aims:
Colorectal cancer patients without lymph node metastasis usually show a favorable prognosis with low recurrence rates; however, there is an increased risk of the development of a second primary cancer. Understanding the features of a second primary cancer is important to establish an effective postoperative follow-up program for colorectal cancer without lymph node metastasis.
Methodology:
The clinicopathological data on 801 patients with Dukes' A and Dukes' B colorectal cancer were examined in respect to second primary cancer.
Results:
In patients with Dukes' A cancer, the incidences of recurrence and second primary cancer were similar. When tumor invasion was limited within subserosa in Dukes' B patients, the incidence of a second primary cancer was almost two-thirds that of recurrence. More than half of the second primary cancers again developed from the colorectum, followed by stomach and lung.
Conclusions:
When colorectal cancer patients without lymph node metastasis show tumor invasion limited within the subserosa, postoperative follow-up should monitor a balance of recurrence with a second primary cancer.
