Post-surgical surveillance in Lynch syndrome--a Cleveland Clinic experience
© Fay et al; licensee BioMed Central Ltd. 2011
Published: 10 March 2011
Post-surgical colonoscopic surveillance is recommended every 1-2 years for patients diagnosed with colon cancer and Lynch syndrome. Patients electing to have a segmental versus colectomy IRA risk developing metachronous colon cancers. The rationale for frequent surveillance is to detect and remove polyps before pathologically advancing to cancer thereby reducing mortality. Does compliance with recommended surveillance eliminate the risk of metachronous cancers?
A database search for MMR+ families enrolled in the Jagelman Inherited Colorectal Cancer Registry was performed. Patients suitable for this study were status post surgery for colon cancer with the surgery and post operative follow-ups being performed at the Cleveland Clinic.
Incidence of polyps and cancer following segmental resection
#FU exams detected polyps
#FU exams detected pathologically advanced polyps*
#FU exams detected cancers
Interval between FU & polyp detected (range= 0.5–4.5 yrs)
Interval between FU & cancer detected (range= 0.5-3 yrs)
Further analysis indicates that if a polyp is detected in a FU exam, it is 28% likely to be pathologically advanced and 16% likely to be cancer.
Compliance with post surgical surveillance guidelines does not eliminate risk of metachronous cancers.
Pathologically advanced polyps and cancers can occur within 1 year status post segmental resection.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.