A predictive model of metachronous colorectal cancer occurrence in Lynch syndrome

Lucio Bertario,Stefano Signoroni,Emanuele Meroni,Paola Sala,Paolo Radice,Antonio Russo,Giovanni Ballardini

doi:10.1186/1897-4287-8-s1-o7

Abstract

A total of 1,604 CRC patients (M/F=1.02, 16.5% <40 yrs old) were considered (600 in group A, 117 B, 530 C and 357 D). During the follow-up, 181 developed metachronous CRC (11 %) and 354 (22%) an extracolonic cancer. The risks of metachronous CRC at 10 years were 21%, 16%, 16%, and 14% for group A, B, C and D, respectively. The predictive variables in the final model comprised for each group were: A) MLHI mutation, the presence of colorectal adenomas and then occurrence of extracolonic cancers, B) occurrence of extracolonic cancers, C) high tumor grade and presence of colorectal adenomas. No significant predictors were identified for group D. AUC values, as a measure of discrimination of the various models, were 0.72, 0.78 and 0.76 for group A, B and C, respectively. Conclusions Metachronous CRC is a long-term moderate risk in LS patients. This suggests to recommend a prophylactic colectomy only to selected patients with well defined characteristics.

Highlights

Lynch Syndrome (LS) correlated colorectal carcinoma (CRC) patients show a tendency towards the development of multiple and metachronous lesions and, for this reason, a surgical prophylactic treatment, as total colectomy, is warranted
Considering the quality of life of patients treated with total colectomy, it is essential to determine risk factors of metachronous CRC
We considered LS or suspected LS CRC patients enrolled by our Institutional Register of Hereditary Colorectal Tumors and submitted to a surgical resection of CRC, excluding those who had a total colectomy

Summary

Introduction

A predictive model of metachronous colorectal cancer occurrence in Lynch syndrome Lucio Bertario1*, Paola Sala1, Paolo Radice2, Stefano Signoroni1, Giovanni Ballardini3, Emanuele Meroni3, Antonio Russo4 Background Lynch Syndrome (LS) correlated colorectal carcinoma (CRC) patients show a tendency towards the development of multiple and metachronous lesions and, for this reason, a surgical prophylactic treatment, as total colectomy, is warranted. Considering the quality of life of patients treated with total colectomy, it is essential to determine risk factors of metachronous CRC.

Results

Conclusion