Multiple primary colorectal carcinoma:a report of 14 cases / 中国普通外科杂志

ABSTRACT

Objective To summarize the experience of multiple primary colorectal carcinoma(MPCRC),to improve the level of diagnosis and treatment of MPCRC.Methods The clinical data of 14 cases of MPCRC seen over a 23-year period were retrospectively analysed.Results Amomg the 14 cases,9 cases were synchronous carcinomas and 5 cases were metachronous carcinomas.In the 14 patients,there were 37 carcinoma lesions and they were located as follows;8 lesions in the sigmoid colon,6 in the splenic flexure,6 in the transverse colon,5 in the hepatic flexure,3 in the ascending colon,9 in the desending colon,4 in the rectum and 3 in the cecum.Pathologic classification19 were adenocarcinoma,7 were tubular adencarcinoma,7 were mucous adenocarcinoma,2 were papillary adenocarcinoma,1 was undifferentiated carcinoma,and 1 was polyp with malignant change.Duckes stagingstage B in 26 cancer lesions;stage C in 10 cancer lesions and stage D in 1 cancer lesion. A total of 21 operations were performed in the 14 patients,including hemicolectomy in 11 instances,extended hemicolectomy in 5,subtotal colectomy in 2,total colectomy in 2,and palliative resection in 1.There was no operative mortality.All 14 cases were followed up for 1～19 years;3 died of cerebral hemorrhage or natural causes.At present,11 patients have survived for 4～17 years. Conclusions The prognosis of MPCRC is good,provided that it is detected early and operation is zealous.Metachronous carcinoma has a better result compared to synchronous carcinoma.The main operation of choice is hemicolectomy or extended hemicolectomy.Total colectomy is considered only when absolutely necessary . Regular postoperative colonoscopy followup should be done.