Presentation Information
[INTS3-5]Clinical outcomes of surgery for multiple synchronous colorectal cancers
*Genta Sawada1, Naoki Yoneda1, Ayumi Nagae1, Shiki Fujino1, Taito Kimura1, Yuri Tanisawa1, Jeongho Moon1, Hiroki Fukunaga1, Osakuni Morimoto1, Shunji Morita1 (1. Department of Surgery, Itami City Hospital, Japan)
Introduction
The incidence of synchronous multiple colorectal cancer is reported to account for 2–7% of all colorectal cancers. Although previous studies have suggested morbidity rates in surgical resection for multiple lesions were comparative to those for solidary lesions, evidence remains limited. We retrospectively evaluated the surgical outcomes of synchronous right- and left-sided colorectal cancer at our institution.
Patients and Methods
Among 1,263 patients who underwent primary tumor resection between January 2014 and December 2025, 16 patients (1.2%) with synchronous right- and left-sided colorectal cancers who underwent simultaneous resection were included. Short-term postoperative outcomes were retrospectively analyzed.
Results
The median age was 73 years (range, 49–87), and 13 patients were male. Tumor locations included right-sided colon + descending colon (n=1), sigmoid colon (n=5), rectosigmoid (n=3), Ra (n=2), and Rb (n=5). Preoperative colonic stenting was performed in 1 patient, neoadjuvant therapy for rectal lesions in 2 patients, and Stage IV disease was present in 3 patients. Early-stage lesions were included in 9 patients.
Surgical approaches were open in 3 patients, laparoscopic in 9, and robotic in 4. The median operative time was 489 min, median blood loss was 100 mL, and median postoperative hospital stay was 15 days. Postoperative complications occurred in 8 patients (50%), including ileus in 3, urinary dysfunction in 2, and Grade III anastomotic leakage in 3. Five of these patients underwent combined right-sided colectomy and LAR/APR, including cases with preoperative treatment, colonic stenting, or lateral lymph node dissection.
Conclusion
Postoperative complications were more common in patients with synchronous right-sided colon cancer and rectal cancer (Ra/Rb). In cases including early-stage lesions, a staged surgical approach may be a reasonable option.
The incidence of synchronous multiple colorectal cancer is reported to account for 2–7% of all colorectal cancers. Although previous studies have suggested morbidity rates in surgical resection for multiple lesions were comparative to those for solidary lesions, evidence remains limited. We retrospectively evaluated the surgical outcomes of synchronous right- and left-sided colorectal cancer at our institution.
Patients and Methods
Among 1,263 patients who underwent primary tumor resection between January 2014 and December 2025, 16 patients (1.2%) with synchronous right- and left-sided colorectal cancers who underwent simultaneous resection were included. Short-term postoperative outcomes were retrospectively analyzed.
Results
The median age was 73 years (range, 49–87), and 13 patients were male. Tumor locations included right-sided colon + descending colon (n=1), sigmoid colon (n=5), rectosigmoid (n=3), Ra (n=2), and Rb (n=5). Preoperative colonic stenting was performed in 1 patient, neoadjuvant therapy for rectal lesions in 2 patients, and Stage IV disease was present in 3 patients. Early-stage lesions were included in 9 patients.
Surgical approaches were open in 3 patients, laparoscopic in 9, and robotic in 4. The median operative time was 489 min, median blood loss was 100 mL, and median postoperative hospital stay was 15 days. Postoperative complications occurred in 8 patients (50%), including ileus in 3, urinary dysfunction in 2, and Grade III anastomotic leakage in 3. Five of these patients underwent combined right-sided colectomy and LAR/APR, including cases with preoperative treatment, colonic stenting, or lateral lymph node dissection.
Conclusion
Postoperative complications were more common in patients with synchronous right-sided colon cancer and rectal cancer (Ra/Rb). In cases including early-stage lesions, a staged surgical approach may be a reasonable option.