We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Risk factors for metachronous colorectal cancer in Lynch syndrome patients: a registry-based observational mono-institutional study cohort.
- Authors
Signoroni, Stefano; Piozzi, Guglielmo Niccolò; Ricci, Maria Teresa; Mancini, Andrea; Morabito, Alberto; Bertario, Lucio; Vitellaro, Marco
- Abstract
Background: Risk factors for metachronous colorectal cancer (mCRC) in Lynch Syndrome (LS) patients are essential for colorectal cancer (CRC) treatment strategy to perform not only a curative but also preventive surgery. The aim of this study was to evaluate the risk factors for mCRC development in LS patients to define the patient subset that may benefit an extended curative and preventive surgical resection. Methods: Patient's clinical history, oncological, molecular and follow-up were collected retrospectively from the Hereditary Digestive Tumors Registry at the National Cancer Institute of Milan. The age-related cumulative risk of mCRC was calculated using the Kaplan–Meier method. Factors significantly associated with mCRC were analyzed with a Cox regression model. Overall and specific competitive risks were also calculated. Results: In a total of 1346 CRC patients, 159 (11.8%) developed a mCRC after a mean follow-up of 138 months from the primary tumor. The independent risk factors reported by a multivariate analysis were: pathogenetic variants in MLH1 and MSH2 (HR 2.96 and 1.91, respectively) and history of colorectal adenomas (HR 1.54); whereas female sex and extended surgery were protective (HR 0.59 and 0.79, respectively). Conclusions: Among a high-risk population for CRC, in particular LS, an extended surgery may be considered in CRC patients with specific risk factors (MLH1 or MSH2 germline pathogenic variants, history of colorectal adenomas) to reduce the risk of mCRC development.
- Subjects
COLORECTAL cancer; HEREDITARY nonpolyposis colorectal cancer; SURGICAL excision; DNA mismatch repair; COHORT analysis; FECAL occult blood tests; SCIENTIFIC observation
- Publication
International Journal of Clinical Oncology, 2020, Vol 25, Issue 9, p1644
- ISSN
1341-9625
- Publication type
Article
- DOI
10.1007/s10147-020-01700-2