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International Journal of Colorectal Disease

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21.04.2020 | Original Article

Analysis of metachronous colorectal neoplasms and survival following segmental or extended resection in patients with hereditary non-polyposis colorectal cancer

verfasst von: Seung Jae Roh, Yoon Hwa Hong, Byung Chang Kim, Hee Jin Chang, Kyung Su Han, Chang Won Hong, Dae Kyung Sohn, Sung Chan Park, Dong Woon Lee, Bun Kim, Ji Yeon Baek, Yong Jun Cha, Moon Ki Choi, Jae Hwan Oh

Erschienen in: International Journal of Colorectal Disease | Ausgabe 7/2020

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Abstract

Purpose

The high incidence of metachronous colorectal tumours in patients with hereditary non-polyposis colorectal cancer (HNPCC) encourages extended resection (ER); however, the optimal surgical approach remains unclear. We evaluated the incidences of metachronous colorectal neoplasms following curative colorectal cancer segmental resection (SR) vs ER in patients with HNPCC and investigated patients’ oncologic outcomes according to surgical modality and mismatch repair status.

Methods

We retrospectively investigated medical records of patients with HNPCC (per the Amsterdam II criteria) treated for primary colon cancer at our institution between 2001 and 2017. All patients underwent intensive endoscopic surveillance.

Results

We included 87 patients (36 who underwent SR and 51 who underwent ER). The cumulative incidence of metachronous adenoma was higher in the SR group. One patient in the SR group (2.8%) and 3 in the ER group (5.9%) developed metachronous colon cancer; the difference was not significant (P = 0.693). Four patients in the SR group (11.1%) and 1 in the ER group (2.0%) developed distant recurrences; again, the difference was not significant (P = 0.155). Moreover, no significant differences were observed in the 5-year overall survival rates of patients in the SR and ER groups (88.2% vs 95.5%, P = 0.446); the same was true for 5-year disease-free survival rates (79.5% vs 91.0%, P = 0.147).

Conclusion

The incidence of metachronous cancer was not significantly different between the ER and SR groups; however, that of cumulative metachronous adenoma was higher in the SR group. Hence, intensive surveillance colonoscopy may be sufficient for patients with HNPCC after non-extensive colon resection.

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Titel: Analysis of metachronous colorectal neoplasms and survival following segmental or extended resection in patients with hereditary non-polyposis colorectal cancer
verfasst von: Seung Jae Roh
Yoon Hwa Hong
Byung Chang Kim
Hee Jin Chang
Kyung Su Han
Chang Won Hong
Dae Kyung Sohn
Sung Chan Park
Dong Woon Lee
Bun Kim
Ji Yeon Baek
Yong Jun Cha
Moon Ki Choi
Jae Hwan Oh
Publikationsdatum: 21.04.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: International Journal of Colorectal Disease / Ausgabe 7/2020
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-020-03583-1

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