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Title: Survival by colon cancer stage and screening interval in Lynch syndrome: a prospective Lynch syndrome database report
Author: Dominguez Valentin, Mev
Seppala, Toni T.
Sampson, Julian R.
Macrae, Finlay
Winship, Ingrid
Evans, D.Gareth
Scott, RodneyJ.
Burn, John
Moslein, Gabriela
Bernstein, Inge
Pylvanainen, Kirsi
Renkonen Sinisalo, Laura
Lepisto, Anna
Lindblom, Annika
Plazzer, John-Paul
Tjandra, Douglas
Thomas, Huw
Green, Kate
Lalloo, Fiona
Crosbie, Emma J.
Hill, James
Capellá, G. (Gabriel)
Pineda Riu, Marta
Navarro, Matilde
Brunet, Joan
Ronlund, Karina
Nielsen, Randi Thyregaard
Yilmaz, Mette
Elvang, Louise Laurberg
Katz, Lior
Nielsen, Maartje
ten Broeke, Sanne W.
Nakken, Sigve
Hovig, Eivind
Sunde, Lone
Kloor, Matthias
Knebel Doeberitz, Magnus v
Ahadova, Aysel
Lindor, Noralane
Steinke Lange, Verena
Holinski Feder, Elke
Mecklin, Jukka-Pekka
Møller, Pål
Keywords: Càncer colorectal
Colorectal cancer
Issue Date: 14-Oct-2019
Publisher: BMC
Abstract: Background: We previously reported that in pathogenic mismatch repair (path_MMR) variant carriers, the incidence of colorectal cancer (CRC) was not reduced when colonoscopy was undertaken more frequently than once every 3 years, and that CRC stage and interval since last colonoscopy were not correlated. Methods: The Prospective Lynch Syndrome Database (PLSD) that records outcomes of surveillance was examined to determine survival after colon cancer in relation to the time since previous colonoscopy and pathological stage. Only path_MMR variants scored by the InSiGHT variant database as class 4 or 5 (clinically actionable) were included in the analysis. Results: Ninety-nine path_MMR carriers had no cancer prior to or at first colonoscopy, but subsequently developed colon cancer. Among these, 96 were 65 years of age or younger at diagnosis, and included 77 path_MLH1, 17 path_ MSH2, and 2 path_MSH6 carriers. The number of cancers detected within < 1.5, 1.5–2.5, 2.5–3.5 and at > 3.5 years after previous colonoscopy were 9, 43, 31 and 13, respectively. Of these, 2, 8, 4 and 3 were stage III, respectively, and only one stage IV (interval 2.5–3.5 years) disease. Ten-year crude survival after colon cancer were 93, 94 and 82% for stage I, II and III disease, respectively (p < 0.001). Ten-year crude survival when the last colonoscopy had been < 1.5, 1.5–2.5, 2.5–3.5 or > 3.5 years before diagnosis, was 89, 90, 90 and 92%, respectively (p = 0.91). Conclusions: In path_MLH1 and path_MSH2 carriers, more advanced colon cancer stage was associated with poorer survival, whereas time since previous colonoscopy was not. Although the numbers are limited, together with our previously reported findings, these results may be in conflict with the view that follow-up of path_MMR variant carriers with colonoscopy intervals of less than 3 years provides significant benefit.
Note: Reproducció del document publicat a:
It is part of: Hereditary Cancer in Clinical Practice, 2019, vol. 17
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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