A systematic review of risk-reducing cancer surgery outcomes for hereditary cancer syndromes

Peacock, Oliver; Waters, Peadar S; Pablos, Jaime Otero de; Boussioutas, Alex; Skandarajah, Anita; Simpson, Jayne; Warrier, Satish; Heriot, Alexander G.

doi:10.1016/j.ejso.2019.06.034

Cited by 7 publications

(7 citation statements)

References 46 publications

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“…Prophylactic surgery with removal of an entire target organ is already used in several genetic syndromes, such as hereditary breast and ovarian cancers, gynaecological cancers in Lynch syndrome, and has proved to improve survival 8 . In these patients the risks of cancer are 40–70% and similar to the 60% risk in main‐duct IPMN and 40% in hereditary pancreatitis 99 , 100 .…”

Section: Discussionmentioning

confidence: 99%

“…main-duct or mixed-type intraductal papillary mucinous neoplasm (IPMN), involving the entire pancreatic duct). [6][7][8] Once diagnosed, these patients have to live with the knowledge that PDAC may develop. This knowledge is a considerable burden for most, especially when considering the very poor survival of PDAC.…”

Section: Introductionmentioning

confidence: 99%

“…hereditary pancreatitis), familial clustering and patients with specific clinical predisposition factors (e.g. main‐duct or mixed‐type intraductal papillary mucinous neoplasm (IPMN), involving the entire pancreatic duct) 6–8 . Once diagnosed, these patients have to live with the knowledge that PDAC may develop.…”

Section: Introductionmentioning

confidence: 99%

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Prophylactic total pancreatectomy in individuals at high risk of pancreatic ductal adenocarcinoma (PROPAN): systematic review and shared decision‐making programme using decision tables

et al. 2020

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Background Individuals with a very high lifetime risk of developing pancreatic ductal adenocarcinoma; for example, hereditary pancreatitis and main-duct or mixed-type intraductal papillary mucinous neoplasm, may wish to discuss prophylactic total pancreatectomy but strategies to do so are lacking. Objective To develop a shared decision-making programme for prophylactic total pancreatectomy using decision tables. Methods Focus group meetings with patients were used to identify relevant questions. Systematic reviews were performed to answer these questions. Results The first tables included hereditary pancreatitis and main-duct or mixed-type intraductal papillary mucinous neoplasm. No studies focused on prophylactic total pancreatectomy in these groups. In 52 studies (3570 patients), major morbidity after total pancreatectomy was 25% and 30-day mortality was 6%. After minimally invasive total pancreatectomy (seven studies, 35 patients) this was, respectively, 13% and 0%. Exocrine insufficiency-related symptoms occurred in 33%. Quality of life after total pancreatectomy was slightly lower compared with the general population. Conclusion The decision tables can be helpful for discussing prophylactic total pancreatectomy with individuals at high risk of pancreatic ductal adenocarcinoma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prophylactic total pancreatectomy in individuals at high risk of pancreatic ductal adenocarcinoma (PROPAN): systematic review and shared decision‐making programme using decision tables

et al. 2020

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“…Recently published guidelines offer recommendations on the management of breast cancer in patients with germline mutations in BRCA1/2, PALB2, CHEK2 and ATM (87). Bilateral prophylactic mastectomy reduces the risk of breast cancer by 95% in patients with BRCA 1&2 mutations, and by 90% in those with a strong family history of breast cancer (88). Prophylactic mastectomy may be performed using many of the techniques described.…”

Section: Risk Reducing Surgerymentioning

confidence: 99%

Evolving Trends in Surgical Management of Breast Cancer: An Analysis of 30 Years of Practice Changing Papers

2021

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The management of breast cancer has evolved into a multidisciplinary evidence-based surgical speciality, with emphasis on conservative surgery. A number of landmark trials have established lumpectomy followed by radiation as the standard of care for many patients. The aim of this study is to construct a narrative review of recent developments in the surgical management of breast cancer and how such developments have impacted surgical practice. A comprehensive literature search of Pubmed was conducted. The latest search was performed on October 31st, 2020. Search terms “breast cancer” were used in combinations with specific key words and Boolean operators relating to surgical management. The reference lists of retrieved articles were comprehensively screened for additional eligible publications. Articles were selected and reviewed based on relevance. We selected publications in the past 10 years but did not exclude commonly referenced and highly regarded previous publications. Review articles and book chapters were also cited to provide reference on details not discussed in the academic literature. This article reviews the current evidence in surgical management of early-stage breast cancer, discusses recent trends in surgical practice for therapeutic and prophylactic procedures and provides commentary on implications and factors associated with these trends.

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“…Los estudios moleculares masivos también permiten conocer las mutaciones de novo que pueden ser en línea germinal o somáticas, identificar pacientes candidatos a terapias blanco y facilitar la selección de la terapia idónea 18,44 . El rápido desarrollo en genética del cáncer en la pasada década ha cambiado el panorama de las pruebas genéticas para diagnosticar el CH y su manejo, y los avances en investigación genética y genómica prometen transformar los enfoques futuros para la prevención, detección y tratamientos [45][46][47][48] .…”

Section: Especialidades Médicas: Diagnóstico Y Manejo Multidisciplinariounclassified

Cáncer hereditario: genes involucrados y diagnóstico genético

Pérez-Ramírez¹,

Bonilla-Delgado²,

Godínez‐Aguilar³

et al. 2021

RHJM

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El cáncer se clasifica como esporádico, familiar y hereditario. El hereditario comprende el 5-10% de todos los casos. Es un grupo de enfermedades causadas por variantes patogénicas de genes involucrados en varios procesos biológicos, asociadas con el riesgo de desarrollar tumores. Dependiendo del patrón de tumores en los miembros de las familias afectadas, se conocen diferentes síndromes de cáncer hereditario, como el síndrome de cáncer de mama-ovario hereditario, el síndrome de Lynch y la neoplasia endocrina múltiple 1. Hasta la fecha se han identificado aproximadamente 100 genes de predisposición a cáncer, con patrón de herencia monogénica, y riesgos del 80 al 100% de desarrollar cáncer a lo largo de la vida. La edad de presentación, la presencia de más de un tumor en un paciente, el patrón tumoral en la familia y el grado de parentesco de los afectados son datos necesarios para el diagnóstico clínico. Se requieren diferentes especialidades médicas para la identificación y manejo adecuados de individuos y familias en riesgo, y es imperativa una evaluación genética para un asesoramiento genético adecuado. El diagnóstico genético es de vital importancia para vigilar a los pacientes y sus familias, emitir recomendaciones quirúrgicas y tomar decisiones terapéuticas.

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A systematic review of risk-reducing cancer surgery outcomes for hereditary cancer syndromes

Cited by 7 publications

References 46 publications

Prophylactic total pancreatectomy in individuals at high risk of pancreatic ductal adenocarcinoma (PROPAN): systematic review and shared decision‐making programme using decision tables

Prophylactic total pancreatectomy in individuals at high risk of pancreatic ductal adenocarcinoma (PROPAN): systematic review and shared decision‐making programme using decision tables

Evolving Trends in Surgical Management of Breast Cancer: An Analysis of 30 Years of Practice Changing Papers

Cáncer hereditario: genes involucrados y diagnóstico genético

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