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[Surgery of hereditary colorectal carcinoma].
Zentralbl Chir. 2000; 125 Suppl 1:23-7.ZC

Abstract

Hereditary colorectal cancer syndromes account for about 7% of all colorectal carcinomas. The most frequent form is Hereditary Nonpolyposis Colorectal Cancer (HNPCC). Identification, cloning and sequence analysis of the predisposing genes enables identification of mutation carriers and non-mutation carriers, respectively. These genetic informations can be used in an individually tailored clinical surveillance program and may ultimately result in standard preventive surgical treatment. In classical FAP the surgical standard is performing a restorative proctocolectomy. It is still unclear now, if this procedure should be modified in attenuated forms (colectomy with ileorectostomy). Due to a high rate of synchronous and metachronous carcinomas a subtotal colectomy in the case of first colon cancer seems to be indicated in HNPCC patients. A proctocolectomy or a restorative proctocolectomy should be weighed in case of carcinomas in the lower rectum. These procedures should be performed under the precondition of identification of the pathogenic germline mutation in the patient, only. In addition, a synchronous prophylactic hysterectomy with oophorectomy should be recommended postmenopausal gene carriers. Intensive counseling of the patient should proceed these preventive procedures involving surgeons, gastroenterologists, geneticists, molecular biologists, gynecologists, physicians and psychologists. It is recommended to have patients treated exclusively in specialized centers. Currently, six interdisciplinary centers for cancer surveillance and early diagnosis in hereditary colorectal cancer are being sponsored in Germany by the Deutsche Krebshilfe since 1999. In the future clinical studies have to be conducted to evaluate the efficacy of extended colorectal resections versus efficacy of surveillance and conventional resections according to general oncological principles.

Authors+Show Affiliations

Klinik und Poliklinik für Viszeral-, Thorax- und Gefässchirurgie, Universitätsklinikum Carl Gusatv Carus, TU Dresden. spisto2522@aol.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

ger

PubMed ID

10929642

Citation

Pistorius, S, et al. "[Surgery of Hereditary Colorectal Carcinoma]." Zentralblatt Fur Chirurgie, vol. 125 Suppl 1, 2000, pp. 23-7.
Pistorius S, Schackert HK, Nagel M, et al. [Surgery of hereditary colorectal carcinoma]. Zentralbl Chir. 2000;125 Suppl 1:23-7.
Pistorius, S., Schackert, H. K., Nagel, M., & Saeger, H. D. (2000). [Surgery of hereditary colorectal carcinoma]. Zentralblatt Fur Chirurgie, 125 Suppl 1, 23-7.
Pistorius S, et al. [Surgery of Hereditary Colorectal Carcinoma]. Zentralbl Chir. 2000;125 Suppl 1:23-7. PubMed PMID: 10929642.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Surgery of hereditary colorectal carcinoma]. AU - Pistorius,S, AU - Schackert,H K, AU - Nagel,M, AU - Saeger,H D, PY - 2000/8/10/pubmed PY - 2000/9/23/medline PY - 2000/8/10/entrez SP - 23 EP - 7 JF - Zentralblatt fur Chirurgie JO - Zentralbl Chir VL - 125 Suppl 1 N2 - Hereditary colorectal cancer syndromes account for about 7% of all colorectal carcinomas. The most frequent form is Hereditary Nonpolyposis Colorectal Cancer (HNPCC). Identification, cloning and sequence analysis of the predisposing genes enables identification of mutation carriers and non-mutation carriers, respectively. These genetic informations can be used in an individually tailored clinical surveillance program and may ultimately result in standard preventive surgical treatment. In classical FAP the surgical standard is performing a restorative proctocolectomy. It is still unclear now, if this procedure should be modified in attenuated forms (colectomy with ileorectostomy). Due to a high rate of synchronous and metachronous carcinomas a subtotal colectomy in the case of first colon cancer seems to be indicated in HNPCC patients. A proctocolectomy or a restorative proctocolectomy should be weighed in case of carcinomas in the lower rectum. These procedures should be performed under the precondition of identification of the pathogenic germline mutation in the patient, only. In addition, a synchronous prophylactic hysterectomy with oophorectomy should be recommended postmenopausal gene carriers. Intensive counseling of the patient should proceed these preventive procedures involving surgeons, gastroenterologists, geneticists, molecular biologists, gynecologists, physicians and psychologists. It is recommended to have patients treated exclusively in specialized centers. Currently, six interdisciplinary centers for cancer surveillance and early diagnosis in hereditary colorectal cancer are being sponsored in Germany by the Deutsche Krebshilfe since 1999. In the future clinical studies have to be conducted to evaluate the efficacy of extended colorectal resections versus efficacy of surveillance and conventional resections according to general oncological principles. SN - 0044-409X UR - https://www.unboundmedicine.com/medline/citation/10929642/[Surgery_of_hereditary_colorectal_carcinoma]_ DB - PRIME DP - Unbound Medicine ER -