Areas of Adenoma in Advanced Colorectal Carcinomas: Relationship to Clinical and Pathological Features

Although most evidence suggests that colorectal carcinomas arise from a preexisting adenoma, some observations support the possibility that colorectal cancers may also develop from a nondysplastic colonic mucosa without preexisting precursor lesions. In order to investigate whether the presence or absence of an adenoma within advanced colorectal carcinomas could be correlated to clinical, pathological and prognostic features, we studied 210 patients resected for colorectal cancer. Sixty-two of the 210 patients (30%) had a cancer containing adenoma (CCA). Sex incidence and cancer dimension, histological degree, intraparietal spread and stage were significantly different in cases of CCA as compared to cases of cancer without adenoma (CWA). Regarding the enclosed adenoma, the tubulovillous type was the more frequently observed type. The patient’s age, the size of the carcinoma and the occurrence of other adenomas in the resected colon were statistically different in relation to the type of residual adenoma. The deaths due to recurrence were significantly more frequent in patients resected for CWA. Our results indicate that CCA shows specific pathological features and probably has a different clinical evolution from CWA.