Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1986 Feb;203(2):123–128. doi: 10.1097/00000658-198602000-00002

A comparison of multiple synchronous colorectal cancer in ulcerative colitis, familial polyposis coli, and de novo cancer.

A J Greenstein, G Slater, T M Heimann, D B Sachar, A H Aufses Jr
PMCID: PMC1251057  PMID: 3947149

Abstract

Multiple synchronous colorectal cancer (MSCC) among 1537 patients (69 with familial polyposis coli (FPC), 780 with ulcerative colitis (UC), and 685 with de novo colorectal (DNC) cancers) admitted to The Mount Sinai Hospital between 1945 and 1981 was tabulated. MSCC occurred in five of 24 cancer patients with FPC (21%), in 12 of 65 cancer patients with UC (18%), but in only 17 of 685 DNC patients (2.5%). The proportions of MSCC cases with more than two synchronous tumors were also much greater in the former two groups (UC 6/12 = 50%, FPC 3/5 = 60%) than in DNC (0/17 = 0%). Multiplicity of cancers is thus a distinguishing feature of UC and FPC. MSCC differed from solitary cancers by association with older age and more advanced stage at diagnosis in patients with FPC and by a rightward shift in anatomic distribution in all patients, especially those with FPC and UC.

Full text

PDF
123

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Appel M. F. Preoperative and postoperative colonoscopy for colorectal carcinoma. Dis Colon Rectum. 1976 Nov-Dec;19(8):664–666. doi: 10.1007/BF02591004. [DOI] [PubMed] [Google Scholar]
  2. BERSACK S. R., HOWE J. S., REHAK E. M. A unique case with roentgenologic evidence of regional enteritis of long duration and histologic evidence of diffuse adenocarcinoma. Gastroenterology. 1958 Apr;34(4):703–710. [PubMed] [Google Scholar]
  3. Bussey H. J., Wallace M. H., Morson B. C. Metachronous carcinoma of the large intestine and intestinal polyps. Proc R Soc Med. 1967 Mar;60(3):208–210. [PMC free article] [PubMed] [Google Scholar]
  4. Clemmensen T., Johansen A. A case of Crohn's disease of the colon associated with adenocarcinoma extending from cardia to the anus. Acta Pathol Microbiol Scand A. 1972;80(1):5–8. doi: 10.1111/j.1699-0463.1972.tb00262.x. [DOI] [PubMed] [Google Scholar]
  5. Deschner E. E. Early proliferative changes in gastrointestinal neoplasia. Am J Gastroenterol. 1982 Apr;77(4):207–211. [PubMed] [Google Scholar]
  6. Devitt J. E., Roth-Moyo L. A., Brown F. N. The significance of multiple adenocarcinomas of the colon and rectum. Ann Surg. 1969 Mar;169(3):364–367. doi: 10.1097/00000658-196903000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Devroede G. J., Taylor W. F., Sauer W. G., Jackman R. J., Stickler G. B. Cancer risk and life expectancy of children with ulcerative colitis. N Engl J Med. 1971 Jul 1;285(1):17–21. doi: 10.1056/NEJM197107012850103. [DOI] [PubMed] [Google Scholar]
  8. EDWARDS F. C., TRUELOVE S. C. THE COURSE AND PROGNOSIS OF ULCERATIVE COLITIS. III. COMPLICATIONS. Gut. 1964 Feb;5:1–22. doi: 10.1136/gut.5.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Enker W. E., Dragacevic S. Multiple carcinomas of the large bowel: a natural experiment in etiology and pathogenesis. Ann Surg. 1978 Jan;187(1):8–11. doi: 10.1097/00000658-197801000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Franklin R., McSwain B. Carcinoma of the colon, rectum, and anus. Ann Surg. 1970 Jun;171(6):811–818. doi: 10.1097/00000658-197006010-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. GOLDGRABER M. B., KIRSNER J. B. CARCINOMA OF THE COLON IN ULCERATIVE COLITIS. Cancer. 1964 May;17:657–665. doi: 10.1002/1097-0142(196405)17:5<657::aid-cncr2820170515>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  12. Glenn F., McSherry C. K. Carcinoma of the distal large bowel: 32-year review of 1,026 cases. Ann Surg. 1966 Jun;163(6):838–849. doi: 10.1097/00000658-196606000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Greenstein A. J., Sachar D. B., Pucillo A., Vassiliades G., Smith H., Kreel I., Geller S. A., Janowitz H. D., Aufses A. H., Jr Cancer in universal and left-sided ulcerative colitis: clinical and pathologic features. Mt Sinai J Med. 1979 Jan-Feb;46(1):25–32. [PubMed] [Google Scholar]
  14. Greenstein A. J., Sachar D. B., Smith H., Pucillo A., Papatestas A. E., Kreel I., Geller S. A., Janowitz H. D., Aufses A. H., Jr Cancer in universal and left-sided ulcerative colitis: factors determining risk. Gastroenterology. 1979 Aug;77(2):290–294. [PubMed] [Google Scholar]
  15. Hancock R. J. Synchronous carcinoma of the colon and rectum. Am Surg. 1975 Sep;41(9):560–563. [PubMed] [Google Scholar]
  16. Heald R. J., Bussey H. J. Clinical experiences at St. Mark's Hospital with multiple synchronous cancers of the colon and rectum. Dis Colon Rectum. 1975 Jan-Feb;18(1):6–10. doi: 10.1007/BF02587230. [DOI] [PubMed] [Google Scholar]
  17. Hinton J. M. Risk of malignant change in ulcerative colitis. Gut. 1966 Oct;7(5):427–432. doi: 10.1136/gut.7.5.427. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Howard E. W., Cavallo C., Hovey L. M., Nelson T. G. Colon and rectal cancer in the young adult. Am Surg. 1975 Apr;41(4):260–265. [PubMed] [Google Scholar]
  19. Hughes R. G., Hall T. J., Block G. E., Levin B., Moossa A. R. The prognosis of carcinoma of the colon and rectum complicating ulcerative colitis. Surg Gynecol Obstet. 1978 Jan;146(1):46–48. [PubMed] [Google Scholar]
  20. JOHNSON J. W., JUDD E. S., DAHLIN D. C. Malignant neoplasms of the colon and rectum i young persons. Arch Surg. 1959 Sep;79:365–372. doi: 10.1001/archsurg.1959.04320090013003. [DOI] [PubMed] [Google Scholar]
  21. Johnson W. R., McDermott F. T., Hughes E. S., Pihl E. A., Milne B. J., Price A. B. Carcinoma of the colon and rectum in inflammatory disease of the intestine. Surg Gynecol Obstet. 1983 Feb;156(2):193–197. [PubMed] [Google Scholar]
  22. Keighley M. R., Thompson H., Alexander-Williams J. Multifocal colonic carcinoma and Crohn's disease. Surgery. 1975 Oct;78(4):534–537. [PubMed] [Google Scholar]
  23. Kewenter J., Ahlman H., Hultén L. Cancer risk in extensive ulcerative colitis. Ann Surg. 1978 Dec;188(6):824–828. doi: 10.1097/00000658-197812000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Langevin J. M., Nivatvongs S. The true incidence of synchronous cancer of the large bowel. A prospective study. Am J Surg. 1984 Mar;147(3):330–333. doi: 10.1016/0002-9610(84)90161-2. [DOI] [PubMed] [Google Scholar]
  25. Lasser A. Synchronous primary adenocarcinomas of the colon and rectum. Dis Colon Rectum. 1978 Jan-Feb;21(1):20–22. doi: 10.1007/BF02586540. [DOI] [PubMed] [Google Scholar]
  26. Lavery I. C., Chiulli R. A., Jagelman D. G., Fazio V. W., Weakley F. L. Survival with carcinoma arising in mucosal ulcerative colitis. Ann Surg. 1982 Apr;195(4):508–512. doi: 10.1097/00000658-198204000-00021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Lee T. K., Barringer M., Myers R. T., Sterchi J. M. Multiple primary carcinomas of the colon and associated extracolonic primary malignant tumors. Ann Surg. 1982 Apr;195(4):501–507. doi: 10.1097/00000658-198204000-00020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Lockhart-Mummery H. E., Ritchie J. K., Hawley P. R. The results of surgical treatment for carcinoma of the rectum of St Mark's Hospital from 1948 to 1972. Br J Surg. 1976 Sep;63(9):673–677. doi: 10.1002/bjs.1800630902. [DOI] [PubMed] [Google Scholar]
  29. Lynch H. T., Harris R. E., Bardawil W. A., Lynch P. M., Guirgis H. A., Swartz M. J., Lynch J. F. Management of hereditary site-specific colon cancer. Arch Surg. 1977 Feb;112(2):170–174. doi: 10.1001/archsurg.1977.01370020064007. [DOI] [PubMed] [Google Scholar]
  30. Lynch H. T., Harris R. E., Lynch P. M., Guirgis H. A., Lynch J. F., Bardawil W. A. Role of heredity in multiple primary cancer. Cancer. 1977 Oct;40(4 Suppl):1849–1854. doi: 10.1002/1097-0142(197710)40:4+<1849::aid-cncr2820400813>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  31. Lynch P. M., Lynch H. T., Harris R. E. Hereditary proximal colonic cancer. Dis Colon Rectum. 1977 Nov-Dec;20(8):661–668. doi: 10.1007/BF02586685. [DOI] [PubMed] [Google Scholar]
  32. MOERTEL C. G., BARGEN J. A., DOCKERTY M. B. Multiple carcinomas of the large intestine: a review of the literature and a study of 261 cases. Gastroenterology. 1958 Jan;34(1):85–98. [PubMed] [Google Scholar]
  33. MOERTEL C. G., DOCKERTY M. B., BAGGENSTOSS A. H. Multiple primary malignant neoplasms. I. Introduction and presentation of data. Cancer. 1961 Mar-Apr;14:221–230. doi: 10.1002/1097-0142(196103/04)14:2<221::aid-cncr2820140202>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  34. Maxfield R. G. Colonoscopy as a routine preoperative procedure for carcinoma of the colon. Am J Surg. 1984 Apr;147(4):477–480. doi: 10.1016/0002-9610(84)90008-4. [DOI] [PubMed] [Google Scholar]
  35. McSherry C. K., Cornell G. N., Glenn F. Carcinoma of the colon and rectum. Ann Surg. 1969 Apr;169(4):502–509. doi: 10.1097/00000658-196904000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Mzabi R., Himal H. S., Demers R., MacLean L. D. A multiparametric computer analysis of carcinoma of the colon. Surg Gynecol Obstet. 1976 Dec;143(6):959–964. [PubMed] [Google Scholar]
  37. Nugent F. W., Haggit R. C., Colcher H., Kutteruf G. C. Malignant potential of chronic ulcerative colitis. Preliminary report. Gastroenterology. 1979 Jan;76(1):1–5. [PubMed] [Google Scholar]
  38. Ohman U. Colorectal carcinoma in patients with ulcerative colitis. Am J Surg. 1982 Sep;144(3):344–349. doi: 10.1016/0002-9610(82)90017-4. [DOI] [PubMed] [Google Scholar]
  39. Reilly J. C., Rusin L. C., Theuerkauf F. J., Jr Colonoscopy: its role in cancer of the colon and rectum. Dis Colon Rectum. 1982 Sep;25(6):532–538. doi: 10.1007/BF02564161. [DOI] [PubMed] [Google Scholar]
  40. Ritchie J. K., Hawley P. R., Lennard-Jones J. E. Prognosis of carcinoma in ulcerative colitis. Gut. 1981 Sep;22(9):752–755. doi: 10.1136/gut.22.9.752. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Simstein N. L., Kovalcik P. J., Cross G. H. Colorectal carcinoma in patients less than 40 years old. Dis Colon Rectum. 1978 Apr;21(3):169–171. doi: 10.1007/BF02586561. [DOI] [PubMed] [Google Scholar]
  42. Slanetz C. A., Jr, Herter F. P., Grinnell R. S. Anterior resection versus abdominoperineal resection for cancer of the rectum and rectosigmoid. An analysis of 524 cases. Am J Surg. 1972 Jan;123(1):110–117. doi: 10.1016/0002-9610(72)90318-2. [DOI] [PubMed] [Google Scholar]
  43. Slater G., Papatestas A. E., Tartter P. I., Mulvihill M., Aufses A. H., Jr Age distribution of right- and left-sided colorectal cancers. Am J Gastroenterol. 1982 Feb;77(2):63–66. [PubMed] [Google Scholar]
  44. Travieso C. R., Jr, Knoepp L. F., Jr, Hanley P. H. Multiple adenocarcinomas of the colon and rectum. Dis Colon Rectum. 1972 Jan-Feb;15(1):1–6. doi: 10.1007/BF02587659. [DOI] [PubMed] [Google Scholar]
  45. WELCH C. E., HEDBERG S. E. COLONIC CANCER IN ULCERATIVE COLITIS AND IDIOPATHIC COLONIC CANCER. JAMA. 1965 Mar 8;191:815–818. doi: 10.1001/jama.1965.03080100033008. [DOI] [PubMed] [Google Scholar]
  46. van Heerden J. A., Beart R. W., Jr Carcinoma of the colon and rectum complicating chronic ulcerative colitis. Dis Colon Rectum. 1980 Apr;23(3):155–159. doi: 10.1007/BF02587618. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES