DMMR status and synchronous lesions predicts metachronous lesions after curative resection for rectal cancer
BackgroundThere are no established standard colonoscopy surveillance protocols for patients after curative rectal cancer resection. We investigated the predictive factors for colorectal neoplasms during surveillance colonoscopies to identify patients who are at risk of developing metachronous neopla...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2025.1510400/full |
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| author | Xijie Chen Xijie Chen Xijie Chen Junguo Chen Junguo Chen Junguo Chen Liang Xu Liang Xu Dezheng Lin Dezheng Lin Dezheng Lin Xiaoling Hong Xiaoling Hong Xiaoling Hong Junsheng Peng Junsheng Peng Junsheng Peng Xiaowen He Xiaowen He Xiaowen He Jiancong Hu Jiancong Hu Jiancong Hu |
| author_facet | Xijie Chen Xijie Chen Xijie Chen Junguo Chen Junguo Chen Junguo Chen Liang Xu Liang Xu Dezheng Lin Dezheng Lin Dezheng Lin Xiaoling Hong Xiaoling Hong Xiaoling Hong Junsheng Peng Junsheng Peng Junsheng Peng Xiaowen He Xiaowen He Xiaowen He Jiancong Hu Jiancong Hu Jiancong Hu |
| author_sort | Xijie Chen |
| collection | DOAJ |
| description | BackgroundThere are no established standard colonoscopy surveillance protocols for patients after curative rectal cancer resection. We investigated the predictive factors for colorectal neoplasms during surveillance colonoscopies to identify patients who are at risk of developing metachronous neoplasms in the residual colorectum.MethodsThis was a single-center, retrospective study that included patients with diagnosis of rectal carcinoma who had undergone curative resection from October 2012 to June 2018. Clinicopathological variables were analyzed by logistic regression analysis to identify risk factors independently associated with metachronous neoplasms in patients that underwent curative rectal cancer surgery.ResultsIn all, 554 patients were included in the analysis. Deficient mismatch repair (dMMR) status was recorded in 20 (3.6%) patients. At the surveillance colonoscopies, 118 patients (21.3%) had metachronous neoplasms while 169 patients (30.5%) had metachronous polyps. The median time interval between index colonoscopy and the last surveillance colonoscopy was 736.5 (476.75–1,082.25) days. Univariable and multivariable analysis showed dMMR status, synchronous adenomas/polyps, surveillance time > 3, and longer surveillance period patients were significant risk factors for development of metachronous lesions; in subgroup analysis, we also found that among rectal cancer patients with synchronous adenomas, adenomas located in the left colon and rectum, and longer surveillance period were independent risk factors for detecting metachronous adenomas.ConclusionsThis study underscored the importance of extended follow-up protocols and targeted surveillance for identifying and managing metachronous lesions in dMMR rectal cancer patients, especially with synchronous adenomas. Further prospective, multicenter studies are needed to validate these results. |
| format | Article |
| id | doaj-art-55abaf1ae01c4cdaa85d501cd7c18a77 |
| institution | Kabale University |
| issn | 2296-875X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Surgery |
| spelling | doaj-art-55abaf1ae01c4cdaa85d501cd7c18a772025-01-21T08:36:57ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-01-011210.3389/fsurg.2025.15104001510400DMMR status and synchronous lesions predicts metachronous lesions after curative resection for rectal cancerXijie Chen0Xijie Chen1Xijie Chen2Junguo Chen3Junguo Chen4Junguo Chen5Liang Xu6Liang Xu7Dezheng Lin8Dezheng Lin9Dezheng Lin10Xiaoling Hong11Xiaoling Hong12Xiaoling Hong13Junsheng Peng14Junsheng Peng15Junsheng Peng16Xiaowen He17Xiaowen He18Xiaowen He19Jiancong Hu20Jiancong Hu21Jiancong Hu22Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of General Surgery (Gastric Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Thoracic Surgery, Thoracic Cancer Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Pathology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Endoscopic Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Endoscopic Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of General Surgery (Gastric Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Endoscopic Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBackgroundThere are no established standard colonoscopy surveillance protocols for patients after curative rectal cancer resection. We investigated the predictive factors for colorectal neoplasms during surveillance colonoscopies to identify patients who are at risk of developing metachronous neoplasms in the residual colorectum.MethodsThis was a single-center, retrospective study that included patients with diagnosis of rectal carcinoma who had undergone curative resection from October 2012 to June 2018. Clinicopathological variables were analyzed by logistic regression analysis to identify risk factors independently associated with metachronous neoplasms in patients that underwent curative rectal cancer surgery.ResultsIn all, 554 patients were included in the analysis. Deficient mismatch repair (dMMR) status was recorded in 20 (3.6%) patients. At the surveillance colonoscopies, 118 patients (21.3%) had metachronous neoplasms while 169 patients (30.5%) had metachronous polyps. The median time interval between index colonoscopy and the last surveillance colonoscopy was 736.5 (476.75–1,082.25) days. Univariable and multivariable analysis showed dMMR status, synchronous adenomas/polyps, surveillance time > 3, and longer surveillance period patients were significant risk factors for development of metachronous lesions; in subgroup analysis, we also found that among rectal cancer patients with synchronous adenomas, adenomas located in the left colon and rectum, and longer surveillance period were independent risk factors for detecting metachronous adenomas.ConclusionsThis study underscored the importance of extended follow-up protocols and targeted surveillance for identifying and managing metachronous lesions in dMMR rectal cancer patients, especially with synchronous adenomas. Further prospective, multicenter studies are needed to validate these results.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1510400/fullmetachronous neoplasmrectal cancerdeficient mismatch repair (dMMR)synchronous lesionscolonoscopy surveillance |
| spellingShingle | Xijie Chen Xijie Chen Xijie Chen Junguo Chen Junguo Chen Junguo Chen Liang Xu Liang Xu Dezheng Lin Dezheng Lin Dezheng Lin Xiaoling Hong Xiaoling Hong Xiaoling Hong Junsheng Peng Junsheng Peng Junsheng Peng Xiaowen He Xiaowen He Xiaowen He Jiancong Hu Jiancong Hu Jiancong Hu DMMR status and synchronous lesions predicts metachronous lesions after curative resection for rectal cancer Frontiers in Surgery metachronous neoplasm rectal cancer deficient mismatch repair (dMMR) synchronous lesions colonoscopy surveillance |
| title | DMMR status and synchronous lesions predicts metachronous lesions after curative resection for rectal cancer |
| title_full | DMMR status and synchronous lesions predicts metachronous lesions after curative resection for rectal cancer |
| title_fullStr | DMMR status and synchronous lesions predicts metachronous lesions after curative resection for rectal cancer |
| title_full_unstemmed | DMMR status and synchronous lesions predicts metachronous lesions after curative resection for rectal cancer |
| title_short | DMMR status and synchronous lesions predicts metachronous lesions after curative resection for rectal cancer |
| title_sort | dmmr status and synchronous lesions predicts metachronous lesions after curative resection for rectal cancer |
| topic | metachronous neoplasm rectal cancer deficient mismatch repair (dMMR) synchronous lesions colonoscopy surveillance |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2025.1510400/full |
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