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Controversies in the surgery of patients with familial adenomatous polyposis and Lynch syndrome

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Abstract

Dominantly inherited syndromes of colorectal cancer predisposition are characterized by multifocal neoplasia with an early age of onset. The risk of colorectal cancer is high in affected patients and care of the patients is based on the aims of cancer prevention and cancer cure. At the same time, quality of life should be disturbed as little as possible. Because patients are generally young, the stakes are high. Injudicious decision-making can have unfortunate effects on patients and families. In this article the controversial aspects of surgery in familial adenomatous polyposis and Lynch syndrome are discussed. Specifically the controversies in familial adenomatous polyposis include the timing and the type of surgery while for Lynch syndrome discussion revolves about prophylactic surgery, primary, secondary and tertiary.

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References

  1. Kravochuck SE, Kalady MF, Burke CA, Heald B, Church JM (2014) Defining HNPCC and Lynch syndrome: What’s in a name? Gut 63:1525–1526

    Article  CAS  PubMed  Google Scholar 

  2. Church JM, McGannon E, Burke C, Clark B (2002) Teenagers with familial adenomatous polyposis: What is their risk for colorectal cancer? Dis Colon Rectum 45:887–889

    Article  PubMed  Google Scholar 

  3. Bülow S (2003) Results of national registration of familial adenomatous polyposis. Gut 52:742–746

    Article  PubMed  PubMed Central  Google Scholar 

  4. Elayi E, Manilich E, Church J (2009) Polishing the crystal ball: knowing genotype improves ability to predict desmoid disease in patients with familial adenomatous polyposis. Dis Colon Rectum 52:1623–1629

    Article  Google Scholar 

  5. Milsom JW, Ludwig KA, Church JM, Garcia-Ruiz A (1997) Laparoscopic total abdominal colectomy with ileorectal anastomosis for familial adenomatous polyposis. Dis Colon Rectum 40:675–678

    Article  CAS  PubMed  Google Scholar 

  6. Church JM, Fazio VW, Lavery IC, Oakley JR, Milsom J, McGannon E (1996) Quality of life prophylactic colectomy and ileorectal anastomosis in patients with familial adenomatous polyposis. Dis Colon Rectum 39:1404–1408

    Article  CAS  PubMed  Google Scholar 

  7. Church J, Burke C, McGannon E, Pastean O, Clark B (2003) Risk of rectal cancer in patients after colectomy and ileorectal anastomosis for familial adenomatous polyposis: a function of available surgical options. Dis Colon Rectum 46:1175–1181

    Article  PubMed  Google Scholar 

  8. Church J, Burke C, McGannon E, Pastean O, Clark B (2001) Predicting polyposis severity by proctoscopy: How reliable is it? Dis Colon Rectum 44:1249–1254

    Article  CAS  PubMed  Google Scholar 

  9. Church J, Xhaja X, LaGuardia L, O’Malley M, Burke C, Kalady M (2015) Desmoids and genotype in familial adenomatous polyposis. Dis Colon Rectum 58:444–448

    Article  PubMed  Google Scholar 

  10. Church JM, Xhaja X, Warrier SK, Laguardia L, O’Malley M, Burke C, Kalady MF (2014) Desmoid tumors do not prevent proctectomy following abdominal colectomy and ileorectal anastomosis in patients with familial adenomatous polyposis. Dis Colon Rectum 57:343–347

    Article  PubMed  Google Scholar 

  11. Lovegrove RE, Constantinides VA, Heriot AG, Athanasiou T, Darzi A, Remzi FH, Nicholls RJ, Fazio VW, Tekkis PP (2006) A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients. Ann Surg 244:18–26

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ozdemir Y, Kalady MF, Aytac E, Kiran RP, Erem HH, Church JM, Remzi FH (2013) Anal transitional zone neoplasia in patients with familial adenomatous polyposis after restorative proctocolectomy and IPAA: incidence, management, and oncologic and functional outcomes. Dis Colon Rectum 56:808–814

    Article  PubMed  Google Scholar 

  13. Church J (2005) Ileoanal pouch neoplasia in familial adenomatous polyposis: an underestimated threat. Dis Colon Rectum 48:1708–1713

    Article  PubMed  Google Scholar 

  14. Haanstra JF, Vasen HF, Sanduleanu S, van der Wouden EJ, Koornstra JJ, Kleibeuker JH, de Vos Tot Nederveen Cappel WH (2013) Quality colonoscopy and risk of interval cancer in Lynch syndrome. Int J Colorectal Dis 28:1643–1649

    Article  CAS  PubMed  Google Scholar 

  15. Mecklin JP, Aarnio M, Läärä E, Kairaluoma MV, Pylvänäinen K, Peltomäki P, Aaltonen LA, Järvinen HJ (2007) Development of colorectal tumors in colonoscopic surveillance in Lynch syndrome. Gastroenterology 133:1093–1098

    Article  PubMed  Google Scholar 

  16. Vasen HF, Abdirahman M, Brohet R, Langers AM, Kleibeuker JH, van Kouwen M et al (2010) One to 2-year surveillance intervals reduce risk of colorectal cancer in families with Lynch syndrome. Gastroenterology 138:2300–2306

    Article  PubMed  Google Scholar 

  17. Kalady MF, McGannon E, Vogel JD, Manilich E, Fazio VW, Church JM (2009) Risk of colorectal adenoma and carcinoma after colectomy for colorectal cancer in patients meeting Amsterdam criteria. Ann Surg 252:507–511

    Google Scholar 

  18. Parry S, Win AK, Parry B, Macrae FA, Gurrin LC, Church JM et al (2011) Metachronous colorectal cancer risk for mismatch repair gene mutation carriers: the advantage of more extensive colon surgery. Gut 60:950–957

    Article  PubMed  Google Scholar 

  19. Haanstra JF, de Vos Tot Nederveen Cappel WH, Gopie JP, Vecht J, Vanhoutvin SA, Cats A et al (2012) Quality of life after surgery for colon cancer in patients with Lynch syndrome: partial versus subtotal colectomy. Dis Colon Rectum 55:653–659

    Article  PubMed  Google Scholar 

  20. Pollett WG, Marion K, Moeslein G, Schneider C, Parry S, Veysey K, Bissett IP, Jones I, Macrae F (2014) Quality of life after surgery in individuals with familial colorectal cancer: does extended surgery have an adverse impact? ANZ J Surg 84:359–364

    Article  PubMed  Google Scholar 

  21. Kalady MF, Lipman J, McGannon E, Church JM (2012) Risk of colonic neoplasia after proctectomy for rectal cancer in hereditary nonpolyposis colorectal cancer. Ann Surg 255:1121–1125

    Article  PubMed  Google Scholar 

  22. Win AK, Parry S, Parry B, Kalady MF, Macrae FA, Ahnen DJ et al (2013) Risk of metachronous colon cancer following surgery for rectal cancer in mismatch repair gene mutation carriers. Ann Surg Oncol 20:1829–1836

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Sanford R. Weiss M.D. Center for Hereditary Colorectal Neoplasia, Victor W. Fazio Chair of Colorectal Surgery, Cleveland Clinic Foundation, Desk A 30, 9500 Euclid Ave., Cleveland, OH, 44195, USA

    James M. Church

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  1. James M. Church
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Correspondence to James M. Church.

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Church, J.M. Controversies in the surgery of patients with familial adenomatous polyposis and Lynch syndrome. Familial Cancer 15, 447–451 (2016). https://doi.org/10.1007/s10689-016-9886-4

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  • DOI: https://doi.org/10.1007/s10689-016-9886-4

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