It has been stated that the microscopic appearance of a recurrent neoplasm will determine whether it represents progression of the original neoplasm or a completely new growth. Normal mucosal glands are observed abruptly adjacent to a recurrent growth, whereas in the metachronous growth the transition from normal to malignant cells at the margin of the growth is gradual. Also, there is a difference in the clinical behavior of recurrent and of metachronous growths. It has been found that the former appear at an average of three years after operation and that the final postoperative survival time is a year and a half. The average interval between operations for primary and for metachronous growths is four years, and the postoperative survival time is about five and a half years. Close follow-up care of all of these patients is necessary in order that carcinomatous transformation can be detected early. Regardless of whether
Dixon CF, Pitchford CA, McCarran SP. INDEPENDENT CARCINOMAS OF COLON OCCURRING TWENTY-ONE YEARS APARTREPORT OF A CASE. JAMA. 1953;151(13):1102. doi:10.1001/jama.1953.02940130048009
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