(this article belongs to the Special Issue Timisoara Morphological Days)

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The objective of the study. Colorectal cancer (CRC) is the third most common neoplasm and the fourth leading cause of cancer death worldwide. About 3.5% of patients develop synchronous colorectal tumors (SCRT). The aim of the study was to evaluate the clinical-pathological characteristics of TSCR, in an attempt to outline the profile of these patients and to identify the parameters associated with the risk of aggressive evolution of the disease. Materials and methods. We performed a retrospective observational study on a group of patients with TSCR diagnosed on surgical resection pieces performed on patients operated on in the County Clinical Emergency Hospital “Pius Brȋnzeu” Timişoara (CCEHPBT), in a ten-year interval (2009 - 2018). Clinical data were collected from the accompanying notes of the biopsy material, from the clinical observation sheets, and the pathological parameters were extracted from the histopathological bulletins from the database of the Pathological Anatomy Service of the CCEHPBT. Results. A number of 73 (4%) cases met the criteria for inclusion in the study. The age of the patients was between 18 and 90 years, the average age being 64.8 years. TSCR were diagnosed more frequently in men (65.76%) and predominantly located in the left colon (47.94%). In most cases, conventional adenocarcinomas were identified - ADK NOS (73.97%), deeply invasive in the intestinal wall - pT3-pT4 (89.04%), with metastases in regional lymphnodules - pN1/pN2 (58.9%), and lympho- vascular – LV1 was identified in 47.95% of cases. Lymph node metastases were more frequent in the elderly (p=0.045) and were associated with pT3-pT4 (p=0.0169) and LV1 (p<0.0001), Table 1, Figure 1. Conclusions. Our study highlights the heterogeneity of the clinical-pathological picture of TSCR patients, which increases the difficulty of therapeutic management. We recommend a thorough examination and long-term clinical surveillance of these cases. In addition, the identification of patients at high risk of multiple tumors as well as prognostic factors is needed as complementary tools for the establishment of personalized therapy.

Keywords: colorectal cancer, synchronous tumors, clinical-pathological features