J.Jpn. Surg. Soc.. 99(6): 357-361, 1998

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Feature topic

FREQUENCY AND CHARACTERISTICS OF SECONDARY CANCER IN THE COLON AND RECTUM AFTER PRIMARY RESECTION

Among 2087 patients who underwent primary resection of colorectal cancer in our department within the past 20 years, 68 (3.2％) were found to have a secondary or additional cancer in their large bowel after the first resection. Statistically significant risk factors in the secondary cancer group were a high incidence of coexisting adenoma and high frequency of colorectal cancer in second-degree relatives.Those in whom secondary cancer occurred were divided into two groups : the adenoma component (AC) group ; and the non-adenoma component (DN) group. Secondary cancer in the DN group revealed lower grade of cell differentiation and more frequent depressed macroscopic findings than in the AC group. As a result, the prognosis of the DN group was worse than that of the AC group (p＜0.05). Based on these results, the recommended follow-up should include colonoscopy in the first years after primary cancer resection and according to the findings of the first colonoscopy the frequency of colonofiberscopic follow-up must be decided.

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