PMID- 32347342 OWN - NLM STAT- MEDLINE DCOM- 20210623 LR - 20210623 IS - 1432-1262 (Electronic) IS - 0179-1958 (Linking) VI - 35 IP - 7 DP - 2020 Jul TI - Analysis of metachronous colorectal neoplasms and survival following segmental or extended resection in patients with hereditary non-polyposis colorectal cancer. PG - 1273-1282 LID - 10.1007/s00384-020-03583-1 [doi] AB - PURPOSE: The high incidence of metachronous colorectal tumours in patients with hereditary non-polyposis colorectal cancer (HNPCC) encourages extended resection (ER); however, the optimal surgical approach remains unclear. We evaluated the incidences of metachronous colorectal neoplasms following curative colorectal cancer segmental resection (SR) vs ER in patients with HNPCC and investigated patients' oncologic outcomes according to surgical modality and mismatch repair status. METHODS: We retrospectively investigated medical records of patients with HNPCC (per the Amsterdam II criteria) treated for primary colon cancer at our institution between 2001 and 2017. All patients underwent intensive endoscopic surveillance. RESULTS: We included 87 patients (36 who underwent SR and 51 who underwent ER). The cumulative incidence of metachronous adenoma was higher in the SR group. One patient in the SR group (2.8%) and 3 in the ER group (5.9%) developed metachronous colon cancer; the difference was not significant (P = 0.693). Four patients in the SR group (11.1%) and 1 in the ER group (2.0%) developed distant recurrences; again, the difference was not significant (P = 0.155). Moreover, no significant differences were observed in the 5-year overall survival rates of patients in the SR and ER groups (88.2% vs 95.5%, P = 0.446); the same was true for 5-year disease-free survival rates (79.5% vs 91.0%, P = 0.147). CONCLUSION: The incidence of metachronous cancer was not significantly different between the ER and SR groups; however, that of cumulative metachronous adenoma was higher in the SR group. Hence, intensive surveillance colonoscopy may be sufficient for patients with HNPCC after non-extensive colon resection. FAU - Roh, Seung Jae AU - Roh SJ AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. FAU - Hong, Yoon Hwa AU - Hong YH AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. FAU - Kim, Byung Chang AU - Kim BC AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. mdzara@ncc.re.kr. FAU - Chang, Hee Jin AU - Chang HJ AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. FAU - Han, Kyung Su AU - Han KS AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. FAU - Hong, Chang Won AU - Hong CW AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. FAU - Sohn, Dae Kyung AU - Sohn DK AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. FAU - Park, Sung Chan AU - Park SC AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. FAU - Lee, Dong Woon AU - Lee DW AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. FAU - Kim, Bun AU - Kim B AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. FAU - Baek, Ji Yeon AU - Baek JY AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. FAU - Cha, Yong Jun AU - Cha YJ AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. FAU - Choi, Moon Ki AU - Choi MK AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. FAU - Oh, Jae Hwan AU - Oh JH AD - Center for Colorectal Cancer, National Cancer Center, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. LA - eng GR - NCC-1810062/National Cancer Center (KR)/ GR - NCC-1610250/National Cancer Center (KR)/ PT - Journal Article DEP - 20200421 PL - Germany TA - Int J Colorectal Dis JT - International journal of colorectal disease JID - 8607899 SB - IM MH - *Colorectal Neoplasms MH - *Colorectal Neoplasms, Hereditary Nonpolyposis/surgery MH - Humans MH - Neoplasm Recurrence, Local MH - *Neoplasms, Second Primary/epidemiology MH - Retrospective Studies OTO - NOTNLM OT - Colorectal cancer OT - HNPCC OT - Lynch syndrome OT - Segmental resection EDAT- 2020/04/30 06:00 MHDA- 2021/06/24 06:00 CRDT- 2020/04/30 06:00 PHST- 2020/04/04 00:00 [accepted] PHST- 2020/04/30 06:00 [pubmed] PHST- 2021/06/24 06:00 [medline] PHST- 2020/04/30 06:00 [entrez] AID - 10.1007/s00384-020-03583-1 [pii] AID - 10.1007/s00384-020-03583-1 [doi] PST - ppublish SO - Int J Colorectal Dis. 2020 Jul;35(7):1273-1282. doi: 10.1007/s00384-020-03583-1. Epub 2020 Apr 21.