Familial Adenomatous Polyposis: Should Patients Undergo Surveillance of the Upper Gastrointestinal Tract?

Abstract

Upper gastrointestinal (UGI) endoscopy was performed in 35 asymptomatic patients with familial adenomatous polyposis (FAP) to assess the prevalence of gastric and duodenal polyps and to demonstrate efficacy of endoscopic surveillance in patients with FAP. UGI polyps were found in 25 (71%) of 35 polyposis patients. Among these, gastric fundic gland polyps were involved in seven patients, and UGI adenomas in 18 patients; there were nine gastric adenomas and 14 duodenal adenomas, including six cases of duodenal cancer. UGI polyps were found in 13 of 15 patients with extracolonic manifestations (87%), but in only 12 of 20 patients (60%) without. The median follow-up interval was 8.7 years in growing duodenal adenomas, but 3.5 years in adenomas without changes in size and number. It was concluded that surveillance gastroduodenoscopy every 3-5 years might be enough to treat duodenal adenomas by endoscopic mucosal resection.

Safety and long-term follow-up of endoscopic snare excision of ampullary adenomas

“…In patients considered to have sporadic or isolated adenomas involving the papilla, the goal of surveillance is to detect recurrence at the excision site. Investigators have suggested that surveillance endoscopy in patients with FAP or GardnerÕs syndrome be performed at intervals of 3-5 years [20,25]. Among the 11 patients in the current study for whom endoscopic follow-up was available, two had residual/ recurrent adenoma 6 and 72 months after the first ERCP, respectively.…”

Familial Gastric Cancers

“…However, current data suggest that it should be started at 21-30 years of age [8] and performed at intervals of 3-5 years [34].…”

Aktuelle Diagnostik und Therapie des Magenkarzinoms

“…Das mittlere Erkrankungsalter liegt bei 62 Jahren, wobei auch zunehmend bei jungen Menschen Karzinome diagnostiziert werden. Neben den klassischen Risikofaktoren, wie der atrophischen Gastritis durch Helicobacter-pylori-Kolonisation und der Korrelation zur Blutgruppe A, wurde in den vergangenen Jahren die Häufung bei Familien mit familiärer adenomatöser Polyposis (FAP), mit Mutationen im E-Cadherin-Gen oder mit HNPCC-Tumoren charakterisiert [3][4][5]. Da Während Neuerkrankungen im distalen Magen rückläufi g sind, steigt in westlichen Industrienationen die Inzidenz der proximalen Magentumoren, insbesondere der Kardia-und Barrett-Karzinome, dramatisch [2].…”