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Am J Surg ; 216(1): 99-105, 2018 07.
Article in English | MEDLINE | ID: mdl-29153248

ABSTRACT

BACKGROUND: This study analyzes the occurrence of colorectal cancer (CRC) in Lynch syndrome (LS) mutation carriers, interval until diagnosis of metachronous CRC, and survival after proximal colectomy (PC) compared with total (TC) and subtotal colectomy (STC) for right-sided first CRC in LS mutation carriers. METHODS: Sixty-four LS mutation carriers with right-sided first CRC treated with PC or TC + STC were confirmed by clinical records. Bivariate analyses were examined for significance and life tables were generated for risk of metachronous CRC and survival estimates following surgery. RESULTS: One of 16 (6.3%) mutation carriers treated with TC + STC developed subsequent CRC compared with 13/48 (27%) treated by PC. There was no significant difference in survival estimates between PC compared with TC + STC through 25 years after surgery. CONCLUSION: Risk of subsequent CRC and survival estimates following PC and TC + STC should be considered in surgical management of right-sided first CRC in LS mutation carriers.


Subject(s)
Colectomy/methods , Colorectal Neoplasms, Hereditary Nonpolyposis/surgery , Colorectal Neoplasms/surgery , DNA, Neoplasm/genetics , Mutation , Adult , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms, Hereditary Nonpolyposis/diagnosis , Colorectal Neoplasms, Hereditary Nonpolyposis/genetics , DNA Mutational Analysis , DNA-Binding Proteins/genetics , Female , Follow-Up Studies , Genotype , Humans , Male , Middle Aged , Mismatch Repair Endonuclease PMS2/genetics , MutL Protein Homolog 1/genetics , MutS Homolog 2 Protein/genetics , Retrospective Studies , Risk Factors
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