Abstract | BACKGROUND: METHODS: Parametric survival analysis was used to identify predictors of progressive rectal disease in all patients undergoing an IRA for FAP at a single centre. Hazard ratios (HRs) were calculated for phenotype, genotype, sex, age at surgery and presence of colonic cancer. RESULTS: Of 427 patients who underwent IRA, 48 (11.2 per cent) developed rectal cancer and 77 (18.0 per cent) required proctectomy for worsening polyposis over a median follow-up of 15 (range 7-25) years. By the age of 60 years half of the patients retained their rectum. Rectal polyp count exceeding 20 (HR 30.99, 95 per cent confidence interval 9.57 to 100.32; P < 0.001), APC mutation codon 1250-1450 (HR 3.91, 1.45 to 10.51; P = 0.007), colonic polyp count 500 or more (HR 2.18, 1.24 to 3.82; P = 0.006) and age less than 25 years at the time of surgery (HR 1.99, 1.17 to 3.37; P = 0.011) were independent predictors of progressive rectal disease. CONCLUSION: The risk of proctectomy after IRA for FAP is based on patient genotype, phenotype and age at surgery.
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Authors | A Sinha, P P Tekkis, S Rashid, R K S Phillips, S K Clark |
Journal | The British journal of surgery
(Br J Surg)
Vol. 97
Issue 11
Pg. 1710-5
(Nov 2010)
ISSN: 1365-2168 [Electronic] England |
PMID | 20665483
(Publication Type: Evaluation Study, Journal Article)
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Copyright | Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. |
Topics |
- Adenomatous Polyposis Coli
(genetics, surgery)
- Adolescent
- Adult
- Aged
- Child
- Epidemiologic Methods
- Female
- Humans
- Male
- Middle Aged
- Mutation
(genetics)
- Neoplasm Recurrence, Local
(genetics, surgery)
- Proctocolectomy, Restorative
- Rectal Neoplasms
(genetics, surgery)
- Reoperation
- Young Adult
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