Periampullary adenomas and adenocarcinomas in familial adenomatous polyposis: Cumulative risks and APC gene mutations

Björk, Jan; Åkerbrant, Helena I.; Iselius, Lennart; Bergman, Annika; Engwall, Yvonne; Wahlström, Jan; Martinsson, Tommy; Nordling, Margareta; Hultcrantz, Rolf

doi:10.1053/gast.2001.28707

Cited by 233 publications

(148 citation statements)

References 37 publications

(41 reference statements)

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“…Progression to higher stages occurs over time with one study showing 15% of patients progressing from stages 0-III to stage IV disease over a period of 8 years [Bulow et al 2004]. The risk of developing stage IV disease by age 70 is estimated to be between 20% and 50% [Bjork et al 2001;Bulow et al 2004;Heiskanen et al 1999].…”

Section: Duodenal Adenomas In Familial Adenomatous Polyposismentioning

confidence: 99%

Endoscopic management of nonampullary duodenal polyps

Basford

Bhandari

2011

Therap Adv Gastroenterol

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Duodenal polyps are a rare finding in patients presenting for gastroscopy, being found in 0.3-4.6% of cases. The majority of patients are asymptomatic. The most common lesions necessitating removal are duodenal adenomas which should be differentiated from other mucosal lesions such as ectopic gastric mucosa, and submucosal lesions such as carcinoids and gastrointestinal stromal tumours (GISTs). Adenomas can occur sporadically or as part of a polyposis syndrome. Both groups carry malignant potential but this is higher in patients with a polyposis syndrome. The majority of sporadic duodenal adenomas are flat or sessile and occur in the second part of the duodenum. Historically duodenal adenomas have been managed by radical surgery, which carried significant mortality and morbidity, or more conservative local surgical excision which resulted in high local recurrence rates. There is growing evidence for the use of endoscopic mucosal resection (EMR) techniques for treatment of sporadic nonampullary duodenal adenomas, with good outcomes and low complication rates. Endoscopic submucosal dissection (ESD) carries greater risk of complications and should be reserved for experts in this technique. Patients with sporadic duodenal adenomas carry an increased risk of colonic neoplasia and should be offered colonoscopy. The impact of endoscopic resection on the course of polyposis syndromes such as familial adenomatous polyposis (FAP) needs further study.

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Section: Duodenal Adenomas In Familial Adenomatous Polyposismentioning

confidence: 99%

Endoscopic management of nonampullary duodenal polyps

Basford

Bhandari

2011

Therap Adv Gastroenterol

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“…9,10,24 Because our aim was to study the association between ampullary cancer and sporadic colorectal cancer, all patients who had colon cancer with International Classification of Diseases site/histology code 8220-1 (adenocarcinoma in familial polyposis coli) were excluded from the current analysis. In addition, because almost all patients with FAP are diagnosed with colon cancer before the fifth decade of life, we restricted the analysis to patients age Ն 50 years.…”

Section: Datamentioning

confidence: 99%

“…7,8 Third, epidemiologic studies suggest a possible bidirectional association between these two types of malignancies. Ampullary cancer as a second primary malignancy in patients with colorectal cancer has been reported several times, and although most of these reports involve patients with FAP, 9,10 there are some reports that suggest that ampullary cancer is associated with hereditary nonpolyposis colon carcinoma 11,12 and also with sporadic colon cancer. 13 A number of population-based studies of second primary malignancies occurring after colorectal cancer have been performed.…”

mentioning

confidence: 99%

Association of ampullary and colorectal malignancies

Das

Neugut

Cooper

et al. 2004

Cancer

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Metal ion‐imprinted polymethacrylate beads with sizes ranging from 100 to 300 μm were prepared by suspension polymerization for the application of selective separation of target metal ions. The metal ion contacting area of the beads was enlarged via pore formation (BET 425 m2/g) using toluene as a porogenic agent. The synthesis of the copper‐imprinted porous beads was verified using FTIR, SEM, and ESCA. Separation capacity and selectivity were investigated carrying out column separation experiments. The selective adsorption behavior of the imprinted beads was significantly affected by flow rate, pH, and metal ion concentration in the solution. Adsorption of the copper ion, the template metal ion, onto the beads was highly selective, compared with other ions such as nickel and zinc, with the selective coefficients at approximately 5–10. The microporous particles possessing such high selectivity has a potential application as novel column packing materials especially requiring high selective efficiency, which is usually not achievable by commercial ion exchange resins. © 2009 American Institute of Chemical Engineers AIChE J, 2009

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“…This estimative clearly demonstrates that the malignant risk of duodenal adenomas is much lower when compared to colonic ones (11,25,26).…”

Section: Discussionmentioning

confidence: 67%

Advanced duodenal neoplasia and carcinoma in familial adenomatous polyposis: outcomes of surgical management

Campos

Bustamante-Lopez

Kanno

et al. 2017

J. Gastrointest. Oncol.

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Background: In addition to the presence of neoplasia in the colon and rectum, patients with familial adenomatous polyposis (FAP) may develop numerous polyps and carcinoma within the upper gastrointestinal tract. Methods:The aim of the present paper was to review the incidence advanced duodenal polyposis or cancer and their surgical outcomes. A retrospective review of patients' records from our department was performed. respectively. Duodenal carcinomas occurred later (55.8 years) when compared to advanced adenomatosis (45.3 years). Three patients were diagnosed due to symptoms, while the others were detected under endoscopic surveillance. Age interval between FAP treatment and duodenal neoplasia diagnosis was 15.3 years . All but one patient underwent duodenopancreatectomy (DP). Two from the 7 patients undergoing DP died, one from pulmonary embolism 30 days after surgery and the other from recurrent T4N0 duodenal tumor. Thus, major operative morbidity and mortality were 12.5%. Conclusions:In this single-center Brazilian series of FAP patients: (I) advanced duodenal neoplasia or cancer requiring surgery occurred in 5.5% of patients; (II) when reaching the fifth decade of life, patients should be carefully evaluated to diagnose and treat early lesions; (III) in spite of the technical complexity of DP, operative morbidity is acceptable in experienced hands; and (IV) continuous surveillance is necessary during follow-up.

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Periampullary adenomas and adenocarcinomas in familial adenomatous polyposis: Cumulative risks and APC gene mutations

Cited by 233 publications

References 37 publications

Endoscopic management of nonampullary duodenal polyps

Endoscopic management of nonampullary duodenal polyps

Association of ampullary and colorectal malignancies

Advanced duodenal neoplasia and carcinoma in familial adenomatous polyposis: outcomes of surgical management

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