Postoperative adjuvant chemotherapy is associated with a lower incidence of colorectal adenomas in patients with previous colorectal cancer

Hee Seung Lee, Sung Bae Kim, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, JaeHee Cheon, Won Ho Kim, Tae Il Kim

Research output: Contribution to journalArticle

Abstract

Background and Aims: The effects of chemotherapeutic agents on the development of colorectal adenomas in patients with previous colorectal cancer (CRC) are not defined. Therefore, we evaluated the potential effect of adjuvant chemotherapy on the incidence of colorectal adenomas in patients with previous CRC. Methods: We selected patients with low-risk stage II CRC with or without postoperative 5-fluorouracil–based adjuvant chemotherapy to reduce selection bias. Among 1808 patients with stage II CRC who underwent colonoscopic surveillance after curative resection of CRC between 2006 and 2013, 192 patients were retrospectively enrolled in this study after matching for age and sex. The patients were divided into 96 patients receiving and 96 patients not receiving 5-fluorouracil–based chemotherapy. Results: Forty patients (41.7%) exhibited colorectal adenomas among 96 patients who received adjuvant chemotherapy, compared with 50 patients (52.1%) with colorectal adenomas among 96 patients who received surgery only. The incidence rate of advanced adenoma was significantly lower in the chemotherapy group than in the nonchemotherapy group (3.1% vs 10.4%, P =.044). After adjustment for clinically relevant factors such as body mass index, aspirin use, metformin use, number of follow-up colonoscopies, and operation type, adjuvant chemotherapy was found to be associated with a decreased incidence of advanced adenoma (odds ratio,.151; 95% confidence interval,.035-.653; P =.011) in patients with stage II CRC. Conclusions: The results showed that chemotherapy in patients with CRC may be associated with a lower risk of colorectal advanced adenoma development.

Original languageEnglish
Pages (from-to)688-694.e2
JournalGastrointestinal Endoscopy
Volume87
Issue number3
DOIs
Publication statusPublished - 2018 Mar 1

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Adjuvant Chemotherapy
Adenoma
Colorectal Neoplasms
Incidence
Drug Therapy
Selection Bias
Metformin
Colonoscopy
Aspirin
Body Mass Index
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Lee, Hee Seung ; Kim, Sung Bae ; Lee, Hyun Jung ; Park, Soo Jung ; Hong, Sung Pil ; Cheon, JaeHee ; Kim, Won Ho ; Kim, Tae Il. / Postoperative adjuvant chemotherapy is associated with a lower incidence of colorectal adenomas in patients with previous colorectal cancer. In: Gastrointestinal Endoscopy. 2018 ; Vol. 87, No. 3. pp. 688-694.e2.
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abstract = "Background and Aims: The effects of chemotherapeutic agents on the development of colorectal adenomas in patients with previous colorectal cancer (CRC) are not defined. Therefore, we evaluated the potential effect of adjuvant chemotherapy on the incidence of colorectal adenomas in patients with previous CRC. Methods: We selected patients with low-risk stage II CRC with or without postoperative 5-fluorouracil–based adjuvant chemotherapy to reduce selection bias. Among 1808 patients with stage II CRC who underwent colonoscopic surveillance after curative resection of CRC between 2006 and 2013, 192 patients were retrospectively enrolled in this study after matching for age and sex. The patients were divided into 96 patients receiving and 96 patients not receiving 5-fluorouracil–based chemotherapy. Results: Forty patients (41.7{\%}) exhibited colorectal adenomas among 96 patients who received adjuvant chemotherapy, compared with 50 patients (52.1{\%}) with colorectal adenomas among 96 patients who received surgery only. The incidence rate of advanced adenoma was significantly lower in the chemotherapy group than in the nonchemotherapy group (3.1{\%} vs 10.4{\%}, P =.044). After adjustment for clinically relevant factors such as body mass index, aspirin use, metformin use, number of follow-up colonoscopies, and operation type, adjuvant chemotherapy was found to be associated with a decreased incidence of advanced adenoma (odds ratio,.151; 95{\%} confidence interval,.035-.653; P =.011) in patients with stage II CRC. Conclusions: The results showed that chemotherapy in patients with CRC may be associated with a lower risk of colorectal advanced adenoma development.",
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Postoperative adjuvant chemotherapy is associated with a lower incidence of colorectal adenomas in patients with previous colorectal cancer. / Lee, Hee Seung; Kim, Sung Bae; Lee, Hyun Jung; Park, Soo Jung; Hong, Sung Pil; Cheon, JaeHee; Kim, Won Ho; Kim, Tae Il.

In: Gastrointestinal Endoscopy, Vol. 87, No. 3, 01.03.2018, p. 688-694.e2.

Research output: Contribution to journalArticle

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AU - Lee, Hee Seung

AU - Kim, Sung Bae

AU - Lee, Hyun Jung

AU - Park, Soo Jung

AU - Hong, Sung Pil

AU - Cheon, JaeHee

AU - Kim, Won Ho

AU - Kim, Tae Il

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N2 - Background and Aims: The effects of chemotherapeutic agents on the development of colorectal adenomas in patients with previous colorectal cancer (CRC) are not defined. Therefore, we evaluated the potential effect of adjuvant chemotherapy on the incidence of colorectal adenomas in patients with previous CRC. Methods: We selected patients with low-risk stage II CRC with or without postoperative 5-fluorouracil–based adjuvant chemotherapy to reduce selection bias. Among 1808 patients with stage II CRC who underwent colonoscopic surveillance after curative resection of CRC between 2006 and 2013, 192 patients were retrospectively enrolled in this study after matching for age and sex. The patients were divided into 96 patients receiving and 96 patients not receiving 5-fluorouracil–based chemotherapy. Results: Forty patients (41.7%) exhibited colorectal adenomas among 96 patients who received adjuvant chemotherapy, compared with 50 patients (52.1%) with colorectal adenomas among 96 patients who received surgery only. The incidence rate of advanced adenoma was significantly lower in the chemotherapy group than in the nonchemotherapy group (3.1% vs 10.4%, P =.044). After adjustment for clinically relevant factors such as body mass index, aspirin use, metformin use, number of follow-up colonoscopies, and operation type, adjuvant chemotherapy was found to be associated with a decreased incidence of advanced adenoma (odds ratio,.151; 95% confidence interval,.035-.653; P =.011) in patients with stage II CRC. Conclusions: The results showed that chemotherapy in patients with CRC may be associated with a lower risk of colorectal advanced adenoma development.

AB - Background and Aims: The effects of chemotherapeutic agents on the development of colorectal adenomas in patients with previous colorectal cancer (CRC) are not defined. Therefore, we evaluated the potential effect of adjuvant chemotherapy on the incidence of colorectal adenomas in patients with previous CRC. Methods: We selected patients with low-risk stage II CRC with or without postoperative 5-fluorouracil–based adjuvant chemotherapy to reduce selection bias. Among 1808 patients with stage II CRC who underwent colonoscopic surveillance after curative resection of CRC between 2006 and 2013, 192 patients were retrospectively enrolled in this study after matching for age and sex. The patients were divided into 96 patients receiving and 96 patients not receiving 5-fluorouracil–based chemotherapy. Results: Forty patients (41.7%) exhibited colorectal adenomas among 96 patients who received adjuvant chemotherapy, compared with 50 patients (52.1%) with colorectal adenomas among 96 patients who received surgery only. The incidence rate of advanced adenoma was significantly lower in the chemotherapy group than in the nonchemotherapy group (3.1% vs 10.4%, P =.044). After adjustment for clinically relevant factors such as body mass index, aspirin use, metformin use, number of follow-up colonoscopies, and operation type, adjuvant chemotherapy was found to be associated with a decreased incidence of advanced adenoma (odds ratio,.151; 95% confidence interval,.035-.653; P =.011) in patients with stage II CRC. Conclusions: The results showed that chemotherapy in patients with CRC may be associated with a lower risk of colorectal advanced adenoma development.

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