Rectal cancer risk in hereditary nonpolyposis colorectal cancer after abdominal colectomy
Rectal cancer risk in hereditary nonpolyposis colorectal cancer after abdominal colectomy
复制标题
DOI：
10.1097/00000658-199702000-00008
复制
发表时间：
1997-02-01
影响因子：
9
通讯作者：
Cutait, R
中科院分区：
文献类型：
--
作者：
RodriguezBigas, MA;Vasen, HFA;Cutait, R
目的分析遗传性非息肉病性结直肠癌（HNPCC）患者经腹结肠切除术后直肠癌的发生率。直肠癌的发病率腹部结肠切除术后，在HNPCC是未知的。材料和方法一份调查问卷邮寄给所有国际合作组HNPCC成员，以确定患者中，直肠癌发展后，全，次全，或完成结肠切除术。采用对数秩检验、Kaplan-Meier法和考克斯比例风险模型进行统计学分析。结果71例患者中有8例（11%）发生直肠癌，其初次手术的中位时间为158个月（范围38-282个月）。在这8名患者中，5名患者的直肠粘膜腺瘤在直肠癌诊断之前（4名）或与直肠癌诊断同时（1名）发生。在诊断直肠癌时，8名患者中有6名正在接受观察。在直肠癌风险的多变量分析中，第一次手术时的年龄和患者是否接受监测是唯一的重要变量（p < 0.05）。发展直肠癌的风险估计为3%，每3年后腹式结肠切除术的第一个12 years.Conclusions直肠癌的风险HNPCC患者腹式结肠切除术后12年约为12%。首次手术和监测时的年龄与直肠癌风险相关。经腹结肠切除术后应积极进行直肠内镜检查。
Objective The authors analyzed the incidence of rectal cancer in patients with hereditary nonpolyposis colorectal cancer (HNPCC) after an abdominal colectomy.Summary Background Data The treatment of choice for a newly diagnosed patient with HNPCC with colon cancer is an abdominal colectomy. The incidence of rectal cancer after abdominal colectomy in HNPCC is not known.Materials and Methods A questionnaire was mailed to all International Collaborative Group on HNPCC members to identify patients in whom rectal cancer developed after total, subtotal, or completion colectomy. Statistics were performed using the log-rank test, Kaplan-Meier method, and Cox's proportional hazards model.Results Rectal cancer developed in 8 (11%) of 71 patients a median of 158 months (range, 38-282 months) from their primary procedure. Of these eight patients, adenomas in the rectal mucosa developed in five al risk either before (4) or synchronous (1) with the diagnosis of rectal cancer. At the time of diagnosis of rectal cancer, six of eight patients were being observed. Age at first procedure and whether the patient was under surveillance were the only significant variables (p < 0.05) in the multivariate analysis in terms of rectal cancer risk. The risk of developing rectal cancer was estimated to be 3% every 3 years after abdominal colectomy for the first 12 years.Conclusions The risk of rectal cancer in patients with HNPCC after an abdominal colectomy is approximately 12% at 12 years. Age at first surgical procedure and surveillance correlated with rectal cancer risk. Aggressive endoscopic surveillance oi the rectum should be performed after abdominal colectomy.