Impact of surgery on the development of duodenal cancer in patients with familial adenomatous polyposis

G. Biasco, E. Nobili, C. Calabrese, R. Sassatelli, L. Camellini, M. A. Pantaleo, G. Bertoni, A. De Vivo, M. Ponz De Leon, G. Poggioli, G. Bedogni, T. Venesio, L. Varesco, M. Risio, G. Di Febo, G. Brandi

Research output: Contribution to journalArticle

Abstract

PURPOSE: Precancerous duodenal lesions in patients with familial adenomatous polyposis can be detected with duodenoscopy and treatment may prevent the development of cancer. We proposed to determine the frequency, natural history, cumulative risk, and risk factors of the precancerous duodenal lesions in a series of patients diagnosed in northern Italy. METHODS: A prospective, endoscopic, follow-up protocol was performed in 50 patients examined by gastroduodenoscopy at two years of interval or less. The presence and severity of precancerous lesions of the duodenal mucosa were evaluated by Spigelman score. Twenty-five patients (50 percent) had proctocolectomy and ileoanal anastomosis, 15 (30 percent) had colectomy and ileorectal anastomosis, and 5 (10 percent) had proctocolectomy and definitive ileostomy from 0 to 3 years before the admission to the surveillance program. All patients showed more than a thousand adenomas in the colorectal mucosa. No patients with attenuated polyposis were found. RESULTS: At the first endoscopy, duodenal adenomas could be detected in 19 of 50 patients (38 percent), whereas at the end of the follow-up, 43 (86 percent) had duodenal lesions. The final mean Spigelman score increased during the follow-up period (P

Original languageEnglish
Pages (from-to)1860-1866
Number of pages7
JournalDiseases of the Colon and Rectum
Volume49
Issue number12
DOIs
Publication statusPublished - Dec 2006

Keywords

  • Duodenal cancer
  • Familial adenomatous polyposis
  • Ileoanal anastomosis
  • Ileorectal anastomosis
  • Ileostomy
  • Spigelman score

ASJC Scopus subject areas

  • Gastroenterology

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    Biasco, G., Nobili, E., Calabrese, C., Sassatelli, R., Camellini, L., Pantaleo, M. A., Bertoni, G., De Vivo, A., Ponz De Leon, M., Poggioli, G., Bedogni, G., Venesio, T., Varesco, L., Risio, M., Di Febo, G., & Brandi, G. (2006). Impact of surgery on the development of duodenal cancer in patients with familial adenomatous polyposis. Diseases of the Colon and Rectum, 49(12), 1860-1866. https://doi.org/10.1007/s10350-006-0723-y