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[Multiple synchronous colorectal carcinomas]

R Pricolo1, P Salvatori, E Rizzitelli

  • 1Divisione di Chirurgia Generale, Ospedale Civile, Casalpusterlengo, Milano.

Minerva Chirurgica
|February 1, 1993
PubMed
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Patients with colon cancer often have multiple tumors or other cancers. A thorough pre-operative examination is crucial for identifying all malignancies, including synchronous and metachronous extracolonic cancers.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Diagnostic Imaging

Background:

  • Colorectal cancer diagnosis and management.
  • Prevalence of multiple and extracolonic malignancies in colon cancer patients.
  • Importance of comprehensive pre-operative evaluation.

Purpose of the Study:

  • To investigate the incidence of multiple synchronous colon cancers.
  • To identify co-occurring extracolonic malignancies in colon cancer patients.
  • To propose criteria for differentiating multiple versus multifocal colon cancers.

Main Methods:

  • Retrospective analysis of 118 colon cancer patients operated between 1986-1990.
  • Pre-operative work-up including Barium enema, colonoscopy, and abdominal ultrasound.

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  • Specific tests for female patients: PAP-test and mammogram.

    • Main Results:

    • Identified 7 cases (5.9%) of multiple synchronous colon cancer.
    • Detected extracolonic malignancy in 3 patients (1 synchronous, 2 metachronous).
    • Proposed new criteria to distinguish multiple from multifocal colon cancers.

    Conclusions:

    • Colon cancer patients have a significant risk of multiple synchronous and extracolonic malignancies.
    • Comprehensive pre-operative colon examination is essential for all colorectal cancer patients.
    • Screening for extracolonic malignancies should be considered in the pre-operative work-up.