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The co-localization of carcinomas and adenomas favors a regional field defect in the colon: an observational study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Finding common genetic alterations in colorectal cancers (CRCs) and peri-tumoral mucosa first led to the notion of colonic field defects. The hypothesis of a genetically determined mosaicism would explain these 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

This is a retrospective observational study. Patients operated for colorectal cancers at an oncological hospital, who had a full colonoscopy performed in the two peri-operative years, were surveyed. Sex, age, familial risk of cancer, tumor and adenoma locations, and the presence of adenomas larger than 1 cm, with villous component or high-grade dysplasia were recorded. Statistics: T test, chi-square, exact, logistic regression (SPSS18®).

Results

This study included 224 patients (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 1 cm (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 that hemicolectomy may always be the surgery of choice for colon cancer.

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Conflicts of interest

Isadora Rosa received consultancy fees from MSD®, AbbVie®, and Dr. Falk Pharma®. She is the lead investigator in an ongoing project for which her institution received a grant from MSD®. She received support for travel/accommodations/meeting expenses from MSD®, AbbVie®, Dr. Falk Pharma® and Hospira®. All of these situations occurred outside the submitted work. The remaining authors have no potential conflicts of interest to disclosure. The study received no financial support.

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Authors and Affiliations

  1. Serviço de Gastrenterologia do Instituto Português de Oncologia de Lisboa, Francisco Gentil (IPOLFG), EPE, Rua Professor Lima Basto, 1099-023, Lisbon, Portugal

    Isadora Rosa & António D. Pereira

  2. Faculdade de Ciências da Saúde da Universidade da Beira Interior, Covilhã, Portugal

    Isadora Rosa, Paula Chaves & António D. Pereira

  3. Serviço de Gastrenterologia, Fundação Champalimaud, Avenida de Brasília, 1400-038, Lisbon, Portugal

    Paulo Fidalgo

  4. Serviço de Anatomia Patológica do IPOLFG, EPE, Rua Professor Lima Basto, 1099-023, Lisbon, Portugal

    Paula Chaves

Authors
  1. Isadora Rosa
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  2. Paulo Fidalgo
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  3. Paula Chaves
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  4. António D. Pereira
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Corresponding author

Correspondence to Isadora Rosa.

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Rosa, I., Fidalgo, P., Chaves, P. et al. The co-localization of carcinomas and adenomas favors a regional field defect in the colon: an observational study. Int J Colorectal Dis 30, 323–327 (2015). https://doi.org/10.1007/s00384-014-2087-4

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  • DOI: https://doi.org/10.1007/s00384-014-2087-4

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