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Synchronous Advanced Colorectal Neoplasia: Clinicopathologic Features and Prognostic Significance.

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Synchronous advanced colorectal neoplasia (SCN) in colorectal cancers (CRCs) is associated with older patients and male predominance. However, SCN does not significantly impact recurrence rates or disease-free survival after treatment.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Oncology

Background:

  • Colorectal cancers (CRCs) can coexist with synchronous advanced colorectal neoplasia (SCN).
  • Understanding the prognostic implications of SCN in CRCs is crucial for patient management.

Purpose of the Study:

  • To compare clinico-pathologic features, recurrence rates, and disease-free survival between CRCs with SCN and solitary CRCs.
  • To determine the prognostic significance of SCN in patients with colorectal cancer.

Main Methods:

  • Retrospective review of prospectively collected data from patients with CRCs (January 2009 - December 2014).
  • Patients categorized into solitary CRCs, CRCs with advanced colorectal adenomas (ACAs), and synchronous colorectal cancers (S-CRCs).
  • Analysis of clinicopathologic features, recurrence rates, and disease-free survival in patients undergoing curative resection and adjuvant treatment.

Main Results:

  • Patients with SCN were significantly older (p <0.01) and SCN was more common in males (15.2%) than females (12.3%) (p=0.045).
  • Among 288 patients with curative resection and adjuvant treatment, 1-, 3-, 5-, 7-, and 10-year recurrence rates were 11.8%, 21.2%, 24.6%, 26.4%, and 26.7%, respectively.
  • Disease-free survival showed no significant difference between groups with SCN and solitary CRCs (p=0.72).

Conclusions:

  • SCN in CRCs is associated with older age and male gender.
  • Curative resection and complete adjuvant treatment result in similar recurrence rates and disease-free survival for CRCs with and without SCN.
  • SCN does not appear to have a significant negative prognostic impact on disease-free survival in CRCs.