Risk Factors for High-Risk Metachronous Lesions During Follow-Up After Colorectal Cancer Resection

Aims A high quality perioperative colonoscopy (HQPC) before surgery or within 6 months following colorectal cancer (CRC) resection is recommended according to recent guidelines. Data on the risk factors for high risk metachronous lesions (HRML) after CRC resection are limited and often conflicting. Our aims are to evaluate the impact of a HQPC in the presence of HRML and determine risk factors for HRML.

Methods Retrospective analysis of patients submitted to curative resection of CRC in our center included in the RORENO database from January 2014 to March 2018, who had at least one endoscopic surveillance. HQPC was considered in the presence of a complete colonoscopy with fair or good bowel cleansing. Time to HRML was estimated using Kaplan–Meier survival analysis and defined as the time elapsed from CRC resection until the event occurs.

Results 195 patients (61.5 % males, median age of 66.8 years-old ±10.6) were evaluated with a mean follow-up of 2 years and 9 months. 90.8 % performed a perioperative colonoscopy, though only 53.3 % with HQPC criteria. After 1 year of follow-up, 6.5 % had HRML and by the end of follow-up HRML were identified in 76.9 % (figure 1). Time to HRML was similar between patients’ with or without a HQPC (log-rank test p=0.13) (figure 2). Male patients (26.7 % vs. 12 %, p=0.01), patients who did not undergo radiotherapy (22.7 % vs. 0 %, p=0.04), patients’ without HQPC (27.5 % vs. 15.4 %, p=0.04) and also with an incomplete perioperative colonoscopy (30.4 % vs. 14 %, p=0.01) had more HRML during follow-up. Adjusting for confounders, only being male (p=0.03, OR=2.9) and having an incomplete perioperative colonoscopy influenced HRML (p=0.03, OR=5) during follow-up.

Conclusions In our sample, almost all patients (90.8 %) with CRC performed a perioperative colonoscopy, although only 53.3 % with HQPC criteria. In our study, a complete perioperative colonoscopy influenced the presence of HRML during follow-up, especially in male patients.

Citation: Garcés-Duran R, Galdin-Ferreyra M, Delgado-Guillena P et al. eP247 RISK FACTORS FOR HIGH-RISK METACHRONOUS LESIONS DURING FOLLOW-UP AFTER COLORECTAL CANCER RESECTION. Endoscopy 2021; 53: S179.

Publication History

Article published online:
19 March 2021