Aim: To analyze the relationship between synchronous lesions in
patients with colorectal cancer and their prognostic value.
Patients and methods: We have retrospectively reviewed 369 patients
with resected colorectal cancer. We compared the rate of apparently
curative surgery, progression and tumoral relapse, development of
extracolonic cancer and mortality between patients with and without
synchronous cancer. Afterwards, we analyzed the same parameters in
colorectal cancer with and without synchronous adenomas. Finally, we
repeated the analysis after stratification of cancers in 2 groups according
to pTNM staging: 0-I-II stage vs III-IV.
Results: We found synchronous adenomas in 54.7% of our patients
and synchronous cancers in 7.6%. Follow-up period of groups with and
without synchronous lesions were: 70.8 ± 22.9 and 67.2 ± 24.5 months (p
= 0.55) respectivelly. Synchronous cancers showed higher mortality:
35.7 vs. 14.4%: p = 0.006; OR = 3.31 (1.33-8.13), higher tumoral progression
: 39.3 vs. 19.1%: p = 0.011; OR = 2.75 (1.14-6.56) and higher
relapse rate: 10.7 vs. 3.5%: p = 0.096. Stratifying according to stage,
patients with stage 0-I-II and synchronous cancer showed worse prognosis:
mortality = 27.7 vs. 8.1%, p = 0.019; OR = 4.45 (1.2-15.1), tumoral
progression = 27.8 vs. 8.5%, p = 0.02; OR = 4.12 (1.14-14.19), and
extracolonic cancer = 16.7 vs. 6.4% p = 0.095. There were no statistical
differences between cases with and without synchronous adenomas.
Conclusions: Synchronous cancers showed worse prognosis after
resection, with higher rate of tumoral progression and mortality. This difference
is focused on the cases diagnosed in stage 0-I-II, not being found in
III-IV. The presence of synchronous adenomas doesn’t influence prognosis