Cancer-specific survival of colorectal adenocarcinomas according to the type of pre-existing adenoma: A Surveillance, Epidemiology, and End Results registry analysis

IF 2.7 2区医学 Q1 SURGERY

Surgery Pub Date : 2025-06-04 DOI:10.1016/j.surg.2025.109468

Sameh Hany Emile MBBCh, MSc, MD, FACS , Zoe Garoufalia MD , Anjelli Wignakumar MBBS, BSc (Hon) , Steven D. Wexner MD, PhD (Hon)

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Abstract

Background

More than 90% of colorectal cancers originate from preexisting adenomas. The present study aimed to assess the association between the type of preexisting adenomas and cancer-specific survival of subsequent colorectal cancer.

Methods

This retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results registry 2000–2020 on patients surgically treated for colorectal adenocarcinomas with known types of preexisting adenomas. Kaplan-Meier statistics and Cox regression analyses were used to assess 5-year cancer-specific survival according to the adenoma types.

Results

The study included 65,365 patients (52.7% male, median age 67 years). Overall, 75.7% of tumors were associated with tubulovillous adenomas, 23.4% with villous adenomas, 0.66% with tubular adenomas, and 0.1% with serrated adenomas. The 5-year cancer-specific survival was best for serrated adenoma-associated carcinomas (87.9%), followed by tubular adenoma-associated carcinomas (84.2%) and tubulovillous adenomas-associated carcinomas (81.5%) whereas villous adenomas-associated carcinomas had the lowest cancer-specific survival (74.1%). The same finding was noted when cancer-specific survival was stratified by disease location and stage. Patients with villous adenomas-associated carcinomas had a lower likelihood of cancer-specific survival compared to tubular adenoma-associated carcinomas (hazard ratio, 1.56, P < .001) whereas tubulovillous adenomas and serrated adenoma-associated carcinomas had a similar risk. However, when adjusted for other survival confounders, the type of preexisting adenoma was not independently associated with cancer-specific survival.

Conclusion

Colorectal adenocarcinomas originating from serrated adenomas and tubular adenomas had the highest 5-year cancer-specific survival. Conversely, villous adenomas-associated adenocarcinomas had the lowest cancer-specific survival. The type of preexisting adenoma was not independently associated with 5-year cancer-specific survival.

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根据先前存在的腺瘤类型，结直肠癌的癌症特异性生存：监测、流行病学和最终结果登记分析

超过90%的结直肠癌起源于先前存在的腺瘤。本研究旨在评估先前存在的腺瘤类型与随后结直肠癌的癌症特异性生存之间的关系。方法本回顾性队列研究采用2000-2020年监测、流行病学和最终结果注册表，研究对象为已知类型既往存在的结直肠腺瘤手术治疗患者。根据腺瘤类型，采用Kaplan-Meier统计和Cox回归分析评估5年肿瘤特异性生存率。结果纳入65,365例患者（52.7%为男性，中位年龄67岁）。总体而言，75.7%的肿瘤与管状绒毛腺瘤相关，23.4%与绒毛腺瘤相关，0.66%与管状腺瘤相关，0.1%与锯齿状腺瘤相关。锯齿状腺瘤相关癌的5年癌症特异性生存率最高（87.9%），其次是管状腺瘤相关癌（84.2%）和管状绒毛状腺瘤相关癌（81.5%），而绒毛状腺瘤相关癌的5年癌症特异性生存率最低（74.1%）。当癌症特异性生存率按疾病位置和分期分层时，同样的发现也被注意到。与管状腺瘤相关癌相比，绒毛腺瘤相关癌患者的癌症特异性生存率较低(风险比，1.56,P <；.001)，而管状绒毛腺瘤和锯齿状腺瘤相关癌的风险相似。然而，当调整其他生存混杂因素时，先前存在的腺瘤类型与癌症特异性生存没有独立的相关性。结论源自锯齿状腺瘤和管状腺瘤的结直肠癌5年肿瘤特异性生存率最高。相反，绒毛腺瘤相关腺癌的癌症特异性生存率最低。先前存在的腺瘤类型与5年癌症特异性生存率无独立相关性。

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来源期刊

Surgery 医学-外科

CiteScore

5.40

自引率

5.30%

发文量

687

审稿时长

64 days

期刊介绍： For 66 years, Surgery has published practical, authoritative information about procedures, clinical advances, and major trends shaping general surgery. Each issue features original scientific contributions and clinical reports. Peer-reviewed articles cover topics in oncology, trauma, gastrointestinal, vascular, and transplantation surgery. The journal also publishes papers from the meetings of its sponsoring societies, the Society of University Surgeons, the Central Surgical Association, and the American Association of Endocrine Surgeons.