Natural history of ampullary adenomas in familial adenomatous polyposis: a long-term follow-up study

Singh, Achintya D.; Bhatt, Amit; Joseph, Abel; Lyu, Ruishen; Heald, Brandie; Macaron, Carole; Líška, Dávid; Burke, Carol A.

doi:10.1016/j.gie.2021.09.036

Cited by 14 publications

(39 citation statements)

References 30 publications

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“…In previous studies, papillary adenoma was detected in 29%‐72% of patients with FAP, and showed slow clinical progression 21,22 . Singh et al demonstrated that the incidence of the development of papillary adenocarcinoma was 1.4% during 7.8 years of follow‐up, and the risk factors for cancerization included male sex, abnormal appearance of papilla, prior cholecystectomy, and history of extracolonic malignancies 23 . On the other hand, gastric adenoma develops in 9%‐50% of FAP patients, and it has been suggested that in Asian countries patients with gastric adenoma are have an increased risk of developing gastric cancer 24 .…”

Section: Discussionmentioning

confidence: 99%

“… 21 , 22 Singh et al demonstrated that the incidence of the development of papillary adenocarcinoma was 1.4% during 7.8 years of follow‐up, and the risk factors for cancerization included male sex, abnormal appearance of papilla, prior cholecystectomy, and history of extracolonic malignancies. 23 On the other hand, gastric adenoma develops in 9%‐50% of FAP patients, and it has been suggested that in Asian countries patients with gastric adenoma are have an increased risk of developing gastric cancer. 24 Martin et al recommended endoscopic treatment for gastric adenomas of >20 mm in size, which are associated with an increased risk of high‐grade dysplasia.…”

Section: Discussionmentioning

confidence: 99%

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Current clinical practice for familial adenomatous polyposis in Japan: A nationwide multicenter study

Matsubara

Beppu

Ikeda

et al. 2022

Annals of Gastroent Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Current clinical practice for familial adenomatous polyposis in Japan: A nationwide multicenter study

Matsubara

Beppu

Ikeda

et al. 2022

Annals of Gastroent Surgery

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“…We assessed the sensitivity of the Spigelman stage IV for duodenal cancer from 9 studies (Figure 3) (21)(22)(23)(24)27,30,(32)(33)(34). Of interest, although the lifetime risk of duodenal cancer was higher for patients with a baseline Spigelman stage IV (21,27), duodenal and papillary cancers frequently occurred in individuals with Spigelman stage III or lower (21,23,31). We estimated a pooled sensitivity of 51% (95% CI 42%-60%) for duodenal and papillary cancers but reaching as low as 39% (95% CI 16%-68%) for papillary cancer (24,27,33).…”

Section: Sensitivity Of the Spigelman Stages For Duodenal And Papilla...mentioning

confidence: 99%

“…For papillary and duodenal cancers, the Spigelman stage at cancer diagnosis ranged from II to IV, indicating a comparable likelihood of Spigelman stage IV between cases and controls (27,31). A single study reported that Spigelman stages III/IV did not predict the risk of a composite end point of papillary neoplastic progression (defined as adenocarcinoma or high-grade dysplasia, HGD) (hazard ratio 1.6; 95% CI 0.49-5.5) (23,32).…”

Section: Sensitivity Of the Spigelman Stages For Duodenal And Papilla...mentioning

confidence: 99%

The Spigelman Staging System and the Risk of Duodenal and Papillary Cancer in Familial Adenomatous Polyposis: A Systematic Review and Meta-Analysis

Mannucci,

Puzzono,

Goel

et al. 2024

Am J Gastroenterol

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Objectives: Individuals with familial adenomatous polyposis (FAP) have an almost 20% lifetime risk of duodenal adenocarcinoma, currently the leading cause of death in FAP. The Spigelman staging system provides guidance on the surveillance intervals and the timing of prophylactic surgery. Still, its accuracy in predicting duodenal and papillary cancer development has not been systematically evaluated. We investigated the sensitivity and cancer risk of the Spigelman stages. Methods: We performed a systematic review on PubMed, MEDLINE, EMBASE, and Cochrane and used a random-effects model to pool effect sizes. Results: After removing duplicate entries, we screened 1170 records and included 27 studies for quantitative analysis. Once duodenal polyposis reaches Spigelman stage IV, the risk of duodenal and papillary cancer increased to 25% (CI95%=12-45%). However, the sensitivity of Spigelman stage IV for these cancers was low (51%, CI95%=42-60%), especially for papillary adenocarcinoma (39%, CI95%=16-68%). We investigated the reasons behind these low values and observed that duodenal cancer risk factors included polyps >10 mm, polyp count >20, and polyps with high-grade dysplasia. Risk factors associated with papillary cancer included a papilla with high-grade dysplasia or >10 mm. The evidence on other risk factors was inconclusive. Conclusions: The current Spigelman staging system had a low sensitivity for duodenal and papillary adenocarcinoma. Two Spigelman variables (duodenal villous histology and polyp count) and the lack of papilla-specific variables likely contributed to the low sensitivity values for duodenal and papillary cancer, respectively. While clinicians may be familiar with its current form, there is an urgent need to update it.

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“…Sulindac and Celecoxib are beneficial in preventing the development of colorectal cancer in persons with the Adenomatous Polyposis Coli (APC) gene mutation [9]. Patients with the APC gene mutation present with adenomas in the colon, which progress into colon cancer if resection is not done [10]. According to Yin et al [11], Aspirin significantly reduces the incidence of colorectal cancer.…”

Section: Introductionmentioning

confidence: 99%

Identification of Potential Drugs for Colorectal Cancer Chemoprevention through Computational Analysis

Kioko¹,

Kagia²

2023

austinjpharmacolther

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Introduction: Colorectal cancer is one of the common causes of hospitalizations, readmission, and poor quality of life due to disability, pain, and death. Most drugs identified to provide chemoprevention in colorectal cancer, such as NSAIDs, have a high level of toxicity. There is need to find novel drugs targeting colorectal cancer with favorable clinical profiles. Objective: The study aimed to identify possible colorectal cancer prevention drugs by comparing the docking scores (representing potential biologic activity) of Aspirin, Sulindac, and Celecoxib with their structurally similar analogs. Materials and Methods: Ligand-based virtual screening and structure-based virtual screening were done for aspirin, sulindac and celecoxib to identify potential drug-like compounds. Compounds that passed the screening, pharmacokinetic profiling, and toxicity testing were considered possible drugs for colorectal cancer chemoprevention. Results: The study identified 7 drug-like compounds from the ZINC database. ZINC02570895, with a better docking score than celecoxib coupled with favorable toxicity and metabolic profiles, was the most appropriate drug candidate for the inhibition of PDK-1. ZINC22309227, with a better docking score and favorable pharmacokinetic profile than sulindac was the most appropriate compound for further development into a MAP Kinase inhibitor. ZINC39406706, ZINC26469982, ZINC01847506, ZINC3382343, and ZINC01682308 had favorable toxicity profiles compared to aspirin and were most suitable for development of cyclooxygenase inhibitors in colorectal cancer prevention. Conclusion: In-vivo and in-vitro tests are needed to ascertain the biological activity, synthesizability and clinical use of the compounds.

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Natural history of ampullary adenomas in familial adenomatous polyposis: a long-term follow-up study

Cited by 14 publications

References 30 publications

Current clinical practice for familial adenomatous polyposis in Japan: A nationwide multicenter study

Current clinical practice for familial adenomatous polyposis in Japan: A nationwide multicenter study

The Spigelman Staging System and the Risk of Duodenal and Papillary Cancer in Familial Adenomatous Polyposis: A Systematic Review and Meta-Analysis

Identification of Potential Drugs for Colorectal Cancer Chemoprevention through Computational Analysis

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