Extensive colectomy in colorectal cancer and hereditary nonpolyposis colorectal cancer – long-term results

Journal of Coloproctology - Tập 39 - Trang 223-230 - 2019
Marisa D. Santos1,2,3, Cláudio Silva1, João Oliveira1, Pedro Brandão1,2,3, Mónica Sampaio1,2,3, Ana Cristina Silva1,2,3, Anabela Rocha1,2,3, Eduarda Matos4, Ricardo Marcos-Pinto3,5
1Centro Hospitalar Universitário do Porto (CHUP), Serviço de Cirurgia, Porto, Portugal
2Centro Hospitalar Universitário do Porto (CHUP), Unidade de Cirurgia Colorretal, Porto, Portugal
3Universidade do Porto, Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
4Universidade do Porto, Instituto de Ciências Biomédicas Abel Salazar, Departamento de Saúde Comunitária, Porto, Portugal
5Centro Hospitalar Universitário do Porto (CHUP), Serviço de Gastroenterologia, Porto, Portugal

Tóm tắt

Abstract Background Colorectal cancer survival is better in hereditary nonpolyposis colorectal cancer patients than in sporadic colorectal cancer patients and even for hereditary nonpolyposis colorectal cancer with colorectal cancer is not consensual that extensive colectomy is preferable to partial colectomy. This study analyzes and compares the long-term results of these two groups of patients submitted to curative subtotal colectomy or total colectomy. Methods Between 2002 and 2018, 68 patients with colorectal cancer without familial adenomatous polyposis were submitted to a total or subtotal colectomy in a single tertiary center. The patients were divided in two groups: hereditary nonpolyposis colorectal cancer patients (with Amsterdam criteria) and sporadic colorectal cancer patients (the others). The presence of Amsterdam criteria for hereditary nonpolyposis colorectal cancer and germline mutation for mismatch repair genes was confirmed by clinical records. Results and survival were analyzed following surgery. Results We obtained a sporadic colorectal cancer group with 31 patients and a hereditary nonpolyposis colorectal cancer group with 37 patients. The two groups differ in age but not in gender, tumor stage or surgical morbidity. The overall survival and disease-free survival were good in both groups but even better for hereditary nonpolyposis colorectal cancer group with statistical significance when comparing the two groups. Conclusion Total or subtotal colectomy for colorectal cancer provides a good survival. These surgical procedures should be considered the first option for colorectal cancer in young hereditary non polyposis colorectal cancer patients. In those cases, they provide good long-term results, avoiding the risk of metachronous colorectal cancer and the surveillance is restricted only to the remaining need for rectum.

Tài liệu tham khảo

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Journal of Coloproctology

Tập 39

223-230

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