Multiple colorectal adenomas syndrome : The role of MUTYH mutation and the polyps' number in clinical management and colorectal cancer risk
Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved..
BACKGROUND & AIMS: Multiple colorectal adenomas (MCRAs) can result from APC (AFAP) or biallelic MUTYH (MAP) mutations, but most patients are wild type and referred to as non-APC/MUTYH polyposis (NAMP). We aim to examine the risk of colorectal cancer (CRC) and the role of endoscopy in managing patients with MCRAs, with a specific focus on clinical features and genotype.
METHODS: Records of MRCAs between 2000 and 2022 were retrospectively analysed. Patients were divided according to the genotype (MAP vs. NAMP) and the number of categorised polyps' burden (group 1: 10-24, group 2: 25-49, and group 3: 50-99 adenomas). Predictors of outcome were CRC-free survival (CRC-FS) and Surgery free-survival (S-FS).
RESULTS: 220 patients were enrolled (NAMP n = 178(80.0%)). CRC at diagnosis was more frequent in group 3 (p = 0.01), without significant differences between the genotypes (p = 0.20). At a follow-up of 83(41-164) months, 15(7%) patients developed CRC during surveillance. CRC-FS was not correlated to genotype (p = 0.07) or polyps' number (p = 0.33), while S-FS was similar in MAP and NAMP (p = 0.22) and lower in groups 2 and 3 (p = 0.0001).
CONCLUSIONS: MAP and NAMP have the same CRC risk and no difference in treatment. Endoscopic surveillance compared favorably with surgery in avoiding CRC risk, even in patients with more severe colorectal polyposis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver - (2023) vom: 08. Dez. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Negro, Silvia [VerfasserIn] |
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| Links: |
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| Themen: |
Colorectal cancer |
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| Anmerkungen: |
Date Revised 09.12.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.dld.2023.11.034 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM365619930 |
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| 100 | 1 | |a Negro, Silvia |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Multiple colorectal adenomas syndrome |b The role of MUTYH mutation and the polyps' number in clinical management and colorectal cancer risk |
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| 500 | |a Date Revised 09.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND & AIMS: Multiple colorectal adenomas (MCRAs) can result from APC (AFAP) or biallelic MUTYH (MAP) mutations, but most patients are wild type and referred to as non-APC/MUTYH polyposis (NAMP). We aim to examine the risk of colorectal cancer (CRC) and the role of endoscopy in managing patients with MCRAs, with a specific focus on clinical features and genotype | ||
| 520 | |a METHODS: Records of MRCAs between 2000 and 2022 were retrospectively analysed. Patients were divided according to the genotype (MAP vs. NAMP) and the number of categorised polyps' burden (group 1: 10-24, group 2: 25-49, and group 3: 50-99 adenomas). Predictors of outcome were CRC-free survival (CRC-FS) and Surgery free-survival (S-FS) | ||
| 520 | |a RESULTS: 220 patients were enrolled (NAMP n = 178(80.0%)). CRC at diagnosis was more frequent in group 3 (p = 0.01), without significant differences between the genotypes (p = 0.20). At a follow-up of 83(41-164) months, 15(7%) patients developed CRC during surveillance. CRC-FS was not correlated to genotype (p = 0.07) or polyps' number (p = 0.33), while S-FS was similar in MAP and NAMP (p = 0.22) and lower in groups 2 and 3 (p = 0.0001) | ||
| 520 | |a CONCLUSIONS: MAP and NAMP have the same CRC risk and no difference in treatment. Endoscopic surveillance compared favorably with surgery in avoiding CRC risk, even in patients with more severe colorectal polyposis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Colorectal cancer | |
| 650 | 4 | |a Colorectal polyposis | |
| 650 | 4 | |a Familial adenomatous polyposis | |
| 650 | 4 | |a MUTYH associated polyposis | |
| 700 | 1 | |a Bao, Quoc Riccardo |e verfasserin |4 aut | |
| 700 | 1 | |a Scarpa, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Scognamiglio, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Pucciarelli, Salvatore |e verfasserin |4 aut | |
| 700 | 1 | |a Remo, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Agostini, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a D'Angelo, Edoardo |e verfasserin |4 aut | |
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| 700 | 1 | |a Guido, Ennio |e verfasserin |4 aut | |
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