Metachronous colorectal cancer: Necessity of post-operative colonoscopic surveillance

Yuan Tzu Lan, Jen Kou Lin*, Anna Fen Yau Li, Tzu Chen Lin, Wei Shone Chen, Jeng Kae Jiang, Shung Haur Yang, Huann Sheng Wang, Shih Ching Chang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Background and aims: The aim of this study was to identify the occurrence and analyze the characteristics of metachronous colorectal cancers, and to compare the characteristics of these cases (index tumor) with the control group to find any predicting factor that may influence the occurrence of metachronous cancer. Patients and methods: The databa se of colorectal cancer in the Veterans General Hospital-Taipei, from January 1981 to September 2001 was reviewed. In total, 3,846 cases of adenocarcinoma of the colon and rectum, which received curative resection during this period, were found. The criteria of metachronous cancer were: occurrence more than 12 months after curative surgery; with pre-operative complete colonoscopy or one negative post-operative colonoscopic follow-up to rule out synchronous tumor; tumor arising from mucosa at a site other than anastomosis. The age, gender of the patients, the location, pathological characteristics of the metachronous tumors, occurrence of associated adenomas, the number of lesions, and the tumor stage were analyzed and compared with the control group. Results: In total, 43 cas es of metachronous cancer were identified, giving an annual incidence of 0.18%. The distribution of the location of the index tumor of metachronous cases was predominantly left-sided, which was not different from that of the control group. The mean duration of occurrence of metachronous cancer after the primary operation was 71±46.6 months. The association of adenomas had no relationship with the occurrence of the metachronous cancer. No significant predicting factors for the development of metachronous tumors were found. Conclusion: Lifelong regular post-operative colonosc opic surveillance is essential for colorectal cancer patients.

Original languageEnglish
Pages (from-to)121-125
Number of pages5
JournalInternational Journal of Colorectal Disease
Issue number2
StatePublished - Mar 2005


  • Carcinoma
  • Colon
  • Index tumor
  • Metachronous
  • Rectum


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