Efficacy of proximal colectomy for surgical management of right-sided first colorectal cancer in Lynch Syndrome mutation carriers

Molly J Hiatt; Murray Joseph Casey; Henry T Lynch; Carrie L Snyder; Mark Stacey; Ryan W Walters

doi:10.1016/j.amjsurg.2017.11.003

Efficacy of proximal colectomy for surgical management of right-sided first colorectal cancer in Lynch Syndrome mutation carriers

Am J Surg. 2018 Jul;216(1):99-105. doi: 10.1016/j.amjsurg.2017.11.003. Epub 2017 Nov 8.

Authors

Molly J Hiatt¹, Murray Joseph Casey², Henry T Lynch³, Carrie L Snyder³, Mark Stacey³, Ryan W Walters⁴

Affiliations

¹ Creighton Hereditary Cancer Center, Department of Preventive Medicine and Public Health, Creighton University, School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA; Department of Obstetrics and Gynecology, Gynecologic Oncology, Creighton University, School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA.
² Creighton Hereditary Cancer Center, Department of Preventive Medicine and Public Health, Creighton University, School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA; Department of Obstetrics and Gynecology, Gynecologic Oncology, Creighton University, School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA. Electronic address: mjcasey@creighton.edu.
³ Creighton Hereditary Cancer Center, Department of Preventive Medicine and Public Health, Creighton University, School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA.
⁴ Division of Clinical Research and Evaluative Sciences, Creighton University, School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA.

PMID: 29153248
DOI: 10.1016/j.amjsurg.2017.11.003

Abstract

Background: This study analyzes the occurrence of colorectal cancer (CRC) in Lynch syndrome (LS) mutation carriers, interval until diagnosis of metachronous CRC, and survival after proximal colectomy (PC) compared with total (TC) and subtotal colectomy (STC) for right-sided first CRC in LS mutation carriers.

Methods: Sixty-four LS mutation carriers with right-sided first CRC treated with PC or TC + STC were confirmed by clinical records. Bivariate analyses were examined for significance and life tables were generated for risk of metachronous CRC and survival estimates following surgery.

Results: One of 16 (6.3%) mutation carriers treated with TC + STC developed subsequent CRC compared with 13/48 (27%) treated by PC. There was no significant difference in survival estimates between PC compared with TC + STC through 25 years after surgery.

Conclusion: Risk of subsequent CRC and survival estimates following PC and TC + STC should be considered in surgical management of right-sided first CRC in LS mutation carriers.

Keywords: Colorectal cancer; Colorectal surgery; Lynch syndrome.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Colectomy / methods*
Colorectal Neoplasms / diagnosis
Colorectal Neoplasms / surgery*
Colorectal Neoplasms, Hereditary Nonpolyposis / diagnosis
Colorectal Neoplasms, Hereditary Nonpolyposis / genetics
Colorectal Neoplasms, Hereditary Nonpolyposis / surgery*
DNA Mutational Analysis
DNA, Neoplasm / genetics*
DNA-Binding Proteins / genetics
Female
Follow-Up Studies
Genotype
Humans
Male
Middle Aged
Mismatch Repair Endonuclease PMS2 / genetics
MutL Protein Homolog 1 / genetics
MutS Homolog 2 Protein / genetics
Mutation*
Retrospective Studies
Risk Factors

Substances

DNA, Neoplasm
DNA-Binding Proteins
G-T mismatch-binding protein
MLH1 protein, human
PMS2 protein, human
MSH2 protein, human
Mismatch Repair Endonuclease PMS2
MutL Protein Homolog 1
MutS Homolog 2 Protein