Long-term prognosis of familial adenomatous polyposis with or without mucosectomy

Tatsuta, Kyota; Sakata, Mayu; Morita, Yoshifumi; Kikuchi, Hirotoshi; Hiramatsu, Yoshihiro; Fukazawa, Atsuko; Kurachi, Kiyotaka; Takeuchi, Hiroya

doi:10.1007/s00384-022-04154-2

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…In a recent national cohort study in Finland, long-term surveillance over approximately 30 years after IRA revealed that 24% of patients developed metachronous rectal cancer (9). Moreover, the rate of metachronous rectal cancer development after stapled IPAA was similar to that after IRA, after a median surveillance period of approximately 19 years (10). Although studies have evaluated the incidence of metachronous rectal cancer (7,8), few have attempted to explore the long-term survival of patients with metachronous rectal cancer.…”

Section: Abstract Aim: To Evaluate the Risk Factors And Long-term Pro...mentioning

confidence: 99%

Long-term Prognostic Impact of Metachronous Rectal Cancer in Patients With Familial Adenomatous Polyposis: A Single-center Retrospective Study

Tatsuta

Sakata

Iwaizumi

et al. 2023

CDP

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Aim: To evaluate the risk factors and long-term prognosis of metachronous rectal cancer in the remnant rectum of patients with familial adenomatous polyposis (FAP). Patients and Methods: Sixty-five patients (49 families) who underwent prophylactic surgery, including bowel resection, for FAP between January 1976 and August 2022 at Hamamatsu University Hospital were included and divided into two groups based on the presence of metachronous rectal cancer. Risk factors for metachronous rectal cancer development were analysed in cases treated with total colectomy with ileorectal anastomosis (IRA) and stapled total proctocolectomy with ileal pouch anal anastomosis (IPAA) (IRA, n=22; stapled IPAA n=20; total, n=42). Results: The median surveillance period was 169 months. Twelve patients developed metachronous rectal cancer (IRA, n=5; stapled IPAA, n=7), of which six with advanced cancer died. Patients who temporarily dropped out of surveillance were significantly more likely to have metachronous rectal cancer (metachronous vs. non-metachronous rectal cancer: 33.3% vs. 1.9%, p<0.01). The mean duration of surveillance suspension was 87.8 months. Cox regression analysis revealed that temporary surveillance drop-out independently affected the risk (p=0.04). The overall survival associated with metachronous rectal cancer was 83.3% at 1 year and 41.7% at 5 years. Overall survival was significantly worse in advanced cancer than in early cancer cases (p<0.01). Conclusion: Temporary drop-out from surveillance was a risk factor for metachronous rectal cancer development, and advanced cancer had a poor prognosis. Continuous surveillance of patients with FAP, without temporary drop-out, is strongly recommended.

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Section: Abstract Aim: To Evaluate the Risk Factors And Long-term Pro...mentioning

confidence: 99%

Long-term Prognostic Impact of Metachronous Rectal Cancer in Patients With Familial Adenomatous Polyposis: A Single-center Retrospective Study

Tatsuta

Sakata

Iwaizumi

et al. 2023

CDP

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Long-term prognosis after stapled and hand-sewn ileal pouch–anal anastomoses for familial adenomatous polyposis: a multicenter retrospective study

Tatsuta,

Sakata,

Iwaizumi

et al. 2024

Int J Colorectal Dis

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Purpose The long-term prognosis of stapled and hand-sewn ileal pouch–anal anastomoses in familial adenomatous polyposis patients in Japan remains unknown. This study aimed to compare the overall survival in familial adenomatous polyposis patients who underwent stapled or hand-sewn ileal pouch–anal anastomosis. Methods This multicenter retrospective study was conducted at 12 institutions in Shizuoka Prefecture, Japan. The clinical outcomes of 53 eligible familial adenomatous polyposis patients who underwent stapled (n = 24) and hand-sewn (n = 29) ileal pouch–anal anastomosis were compared. Results The median follow-up duration was 171.5 months. The incidence of adenoma in the remnant rectum or anal transitional zone and metachronous rectal cancer was significantly more common in stapled ileal pouch–anal anastomosis (adenoma: stapled, 45.8%, vs. hand-sewn, 10.3%, p = 0.005; metachronous rectal cancer: 29.2%, vs. none, p = 0.002). The number of deaths was remarkably higher in stapled ileal pouch–anal anastomosis (p = 0.002). Metachronous rectal cancer was the most common cause of death. Overall survival was worse in stapled ileal pouch–anal anastomosis than in hand-sewn ileal pouch–anal anastomosis (120 months, 90.7% vs. 96.6%; 240 months, 63.7% vs. 96.6%; p = 0.044). Cox regression analysis revealed the independent effects of preoperative advanced colorectal cancer and stapled ileal pouch–anal anastomosis on overall survival. Conclusion Stapled ileal pouch–anal anastomosis negatively affected the overall survival of familial adenomatous polyposis patients. Therefore, hand-sewn ileal pouch–anal anastomosis is recommended for better prognosis in these patients.

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長期サーベイランス中に複数回の腸管切除を要した家族性大腸腺腫症の1例

Shiraki

Mikamo

Tatsuta

et al. 2023

Journal of Japan Society of Coloproctology

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Long-term prognosis of familial adenomatous polyposis with or without mucosectomy

Cited by 3 publications

References 28 publications

Long-term Prognostic Impact of Metachronous Rectal Cancer in Patients With Familial Adenomatous Polyposis: A Single-center Retrospective Study

Long-term Prognostic Impact of Metachronous Rectal Cancer in Patients With Familial Adenomatous Polyposis: A Single-center Retrospective Study

Long-term prognosis after stapled and hand-sewn ileal pouch–anal anastomoses for familial adenomatous polyposis: a multicenter retrospective study

長期サーベイランス中に複数回の腸管切除を要した家族性大腸腺腫症の1例

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