Comparison of extended colectomy and limited resection in patients with lynch syndrome

Nagendra Natarajan, Patrice Watson, Edibaldo Silva-Lopez, Henry T. Lynch

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Purpose: The purpose of the study was to determine the advantages and disadvantages of prophylactic/extended colectomy (subtotal colectomy) in patients with Lynch syndrome who manifest colorectal cancer. Methods: A retrospective cohort using Creighton University's hereditary cancer database was used to identify cases and controls. Cases are patients who underwent subtotal colectomy, either with no colorectal cancer diagnosis (prophylactic) or at diagnosis of first colorectal cancer; controls for these 2 types of cases were, respectively, patients who underwent no colon surgery or those having limited resection at time of diagnosis of first colorectal cancer. The Kaplan-Meier and proportional hazard regression models from the Statistical Analysis Software program was used to calculate the difference in survival, time to subsequent colorectal cancer, and subsequent abdominal surgery between cases and controls. Results: The event-free survival of our study did not reach 50%, so we used the event-free survival at 5 years as our parameter to compare the 2 groups. The event-free survival for subsequent colorectal cancer, subsequent abdominal surgery, and death was 94%, 84%, and 93%, respectively, for cases and 74%, 63%, and 88%, respectively, for controls. Times to subsequent colorectal cancer and subsequent abdominal surgery were significantly shorter in the control group (P <.006 and P <.04, respectively). No significant difference was identified with respect to survival time between the cases and controls. Conclusions: Even though no survival benefit was identified between the cases and controls the increased incidence of metachronous colorectal cancer and increased abdominal surgeries among controls warrant the recommendation of subtotal colectomy in patients with Lynch syndrome.

Original languageEnglish
Pages (from-to)77-82
Number of pages6
JournalDiseases of the Colon and Rectum
Volume53
Issue number1
DOIs
StatePublished - Jan 2010

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Hereditary Nonpolyposis Colorectal Neoplasms
Colectomy
Colorectal Neoplasms
Disease-Free Survival
Survival
Proportional Hazards Models
Colon
Software
Regression Analysis
Databases
Control Groups
Incidence

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Comparison of extended colectomy and limited resection in patients with lynch syndrome. / Natarajan, Nagendra; Watson, Patrice; Silva-Lopez, Edibaldo; Lynch, Henry T.

In: Diseases of the Colon and Rectum, Vol. 53, No. 1, 01.2010, p. 77-82.

Research output: Contribution to journalArticle

Natarajan, Nagendra ; Watson, Patrice ; Silva-Lopez, Edibaldo ; Lynch, Henry T. / Comparison of extended colectomy and limited resection in patients with lynch syndrome. In: Diseases of the Colon and Rectum. 2010 ; Vol. 53, No. 1. pp. 77-82.
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