Risk of Colonic Neoplasia After Proctectomy for Rectal Cancer in Hereditary Nonpolyposis Colorectal Cancer

Kalady, Matthew F.; Lipman, Jeremy M.; McGannon, Ellen; Church, James M.

doi:10.1097/sla.0b013e3182565c0b

Cited by 63 publications

(31 citation statements)

References 32 publications

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“…Best oncologic outcome is balanced by competing risks from extra colonic cancers and metachronous disease with preservation of sphincter function and quality of life issues (Coffey et al, 2002;Wertzberger et al, 2014). The risk of metachronous colon cancer has been reported as 19% at 10 years (Cirillo et al, 2013;Kalady et al, 2012;Lee et al, 2001;Win et al, 2013) with an up to a six-fold increase in mortality risk if a metachronous cancer develops (Cirillo et al, 2013). Thus, an aggressive approach is warranted in disease recurrence and/or metachronous CRC.…”

Section: Rectal Cancer With Msimentioning

confidence: 99%

The current value of determining the mismatch repair status of colorectal cancer: A rationale for routine testing

Ryan

Sheahan

Creavin

et al. 2017

Critical Reviews in Oncology/Hematology

118

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Section: Rectal Cancer With Msimentioning

confidence: 99%

The current value of determining the mismatch repair status of colorectal cancer: A rationale for routine testing

Ryan

Sheahan

Creavin

et al. 2017

Critical Reviews in Oncology/Hematology

118

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“…7, 8 If the diagnosis of Lynch syndrome is known prior to the initial resection, the first question is whether to recommend a total proctocolectomy or a proctectomy. A total proctocolectomy with a permanent ileostomy or a restorative ileal pouch anal anastomosis (IPAA) will prevent the development of metachronous colon cancer but is associated with substantial issues related to postoperative morbidity and quality of life, including requirement of dietary restriction, incontinence or urgency, and decreased sexual function that would be expected to be similar to patients undergoing this operation for familial adenomatous polyposis (FAP).…”

mentioning

confidence: 99%

“…There are 3 series that reported 15–54 % of rectal cancer patients developed a metachronous colon cancer over a relatively short follow-up period. 8, 12, 13 This study aimed to quantify the risk of metachronous colon cancer following surgery for index rectal cancer in a large cohort of MMR gene mutation carriers from a 4-nation collaborative group over a long study interval.…”

mentioning

confidence: 99%

Risk of Metachronous Colon Cancer Following Surgery for Rectal Cancer in Mismatch Repair Gene Mutation Carriers

et al. 2013

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Background Despite regular surveillance colonoscopy, the metachronous colorectal cancer risk for mismatch repair (MMR) gene mutation carriers after segmental resection for colon cancer is high and total or subtotal colectomy is the preferred option. However, if the index cancer is in the rectum, management decisions are complicated by considerations of impaired bowel function. We aimed to estimate the risk of metachronous colon cancer for MMR gene mutation carriers who underwent a proctectomy for index rectal cancer. Methods This retrospective cohort study comprised 79 carriers of germline mutation in a MMR gene (18 MLH1, 55 MSH2, 4 MSH6, and 2 PMS2) from the Colon Cancer Family Registry who had had a proctectomy for index rectal cancer. Cumulative risks of metachronous colon cancer were calculated using the Kaplan–Meier method. Results During median 9 years (range 1–32 years) of observation since the first diagnosis of rectal cancer, 21 carriers (27 %) were diagnosed with metachronous colon cancer (incidence 24.25, 95 % confidence interval [CI] 15.81–37.19 per 1,000 person-years). Cumulative risk of metachronous colon cancer was 19 % (95 % CI 9–31 %) at 10 years, 47 (95 % CI 31–68 %) at 20 years, and 69 % (95 % CI 45–89 %) at 30 years after surgical resection. The frequency of surveillance colonoscopy was 1 colonoscopy per 1.16 years (95 % CI 1.01–1.31 years). The AJCC stages of the metachronous cancers, where available, were 72 % stage I, 22 % stage II, and 6 % stage III. Conclusions Given the high metachronous colon cancer risk for MMR gene mutation carriers diagnosed with an index rectal cancer, proctocolectomy may need to be considered.

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“…However, Kalady et al found a risk of metachronous advanced neoplasia (cancer and severe dysplasia) of 51% in hnPCC patients who had an anterior resection for rectal cancer. 160 Win et al found the overall risk of cancer to be 24.5% and a cumulative risk to 30 years of 69%. 33 therefore, total proctocolectomy with ileal pouch-anal anastomosis is an important option to discuss with patients with rectal cancer and ls.…”

Section: Pancreatic Cancermentioning

confidence: 97%

Guidelines on Genetic Evaluation and Management of Lynch Syndrome

Giardiello

Allen

Axilbund

et al. 2014

Diseases of the Colon &Amp; Rectum

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The Multi-Society Task Force, in collaboration with invited experts, developed guidelines to assist health care providers with the appropriate provision of genetic testing and management of patients at risk for and affected with Lynch syndrome as follows: provides a colorectal cancer risk assessment tool to screen individuals in the office or endoscopy setting; illustrates a strategy for universal screening for Lynch syndrome by tumor testing of patients diagnosed with colorectal cancer; -6 provide algorithms for genetic evaluation of affected and at-risk family members of pedigrees with Lynch syndrome; provides guidelines for screening at-risk and affected persons with Lynch syndrome; and lists the guidelines for the management of patients with Lynch syndrome. A detailed explanation of Lynch syndrome and the methodology utilized to derive these guidelines, as well as an explanation of, and supporting literature for, these guidelines are provided.

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Risk of Colonic Neoplasia After Proctectomy for Rectal Cancer in Hereditary Nonpolyposis Colorectal Cancer

Cited by 63 publications

References 32 publications

The current value of determining the mismatch repair status of colorectal cancer: A rationale for routine testing

The current value of determining the mismatch repair status of colorectal cancer: A rationale for routine testing

Risk of Metachronous Colon Cancer Following Surgery for Rectal Cancer in Mismatch Repair Gene Mutation Carriers

Guidelines on Genetic Evaluation and Management of Lynch Syndrome

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