Narrative review comparing the epidemiology, characteristics, and survival in sporadic colorectal carcinoma/Lynch syndrome

Abstract

Introduction Colorectal carcinoma is the third most prevalent neoplasm in the world, and the second cause of death by cancer. The most part of these neoplasms are sporadic by somatic mutations, but around 15% are hereditary, such as Lynch syndrome or hereditary nonpolyposis colorectal cancer (HNPCC). Despite being the same tumor, it has differences between these two contexts as well as different prognosis. In Lynch syndrome cases, the survival of these individuals was greater than that observed in sporadic cases. Methods This review focuses on the different characteristics and development of colorectal carcinoma in sporadic and Lynch syndrome cases, in order to conclude what may motivate the greater survival in the tumors associated with this syndrome. Results Although the histopathological features drive into a worse prognosis, the colorectal carcinoma in the Lynch Syndrome presents a greater survival comparing to sporadic colorectal carcinoma. Discussion The greater survival in the colorectal carcinoma in the HNPCC compared to the sporadic carcinomas has been linked to factors such as high microsatellite instability, diploid predominance, earlier screening for colo-rectal carcinoma, deficient DNA repair mechanism, low p53 mutation rate, and presence of lymphoid aggregates involving the neoplasm. Conclusion Further studies should be conducted to provide new insights about survival of colorectal carcinoma in Lynch syndrome, as well as the therapeutic alternatives for this neoplasia.

Molecular Analysis of Colorectal Cancers Suggests a High Frequency of Lynch Syndrome in Indonesia

“…Despite previously reports in the literature that LS patients have better long-term survival prognosis than sporadic CRC patients [ 64 , 65 , 66 ], comparable overall survival was observed in this study between the “Probable Lynch” and the non-LS (sporadic) groups. Consistent with the findings from the larger cohort of CRC ( n = 1276) (Hutajulu et al, under review) and with previous reports on selected cases of CRC of local patients, ECOG index played an important role in predicting the OS [ 67 ].…”

Characterization of sebaceous and non-sebaceous cutaneous manifestations in patients with lynch syndrome: a systematic review

“…Prevention and/or early detection of cancer in patients with Lynch Syndrome is associated with increased survival [15]. The link between LS and sebaceous skin manifestations is well established [16].…”

“…In a small but substantial minority (34.7%) of patients, the cutaneous lesion predated the visceral tumours by a median of 1 year (0-19). In those patients where LS was not immediately recognised, the interval between diagnosis of cutaneous and visceral tumours was prolonged, up to a median of 7 years (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”