Abstract | BACKGROUND: METHODS: We evaluated the incidence of rectal cancer in polyposis patients who had undergone IRA, and examined whether the requirement for subsequent rectal excision because of cancer or uncontrollable polyps was related to the site of mutation. FINDINGS: Between 1956 and mid-1995, 225 patients registered at the Netherlands Polyposis Registry had undergone IRA. In 87 of them, a pathogenetic mutation was detected. 72 patients had a mutation located before codon 1250 and 15 patients after this codon. The cumulative risk of rectal cancer 20 years after surgery was 12%, and at that time 42% had undergone rectal excision. The risk of secondary surgery was higher in patients with mutations in the region after codon 1250 than in patients with mutations before this codon (relative risk 2.7, p < 0.05). INTERPRETATION: On this evidence, IRA should be the primary treatment for polyposis in patients with mutations before codon 1250, and RPC in those with mutations after this codon.
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Authors | H F Vasen, R B van der Luijt, J F Slors, E Buskens, P de Ruiter, C G Baeten, W R Schouten, H J Oostvogel, J H Kuijpers, C M Tops, P Meera Khan |
Journal | Lancet (London, England)
(Lancet)
Vol. 348
Issue 9025
Pg. 433-5
(Aug 17 1996)
ISSN: 0140-6736 [Print] England |
PMID | 8709782
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Adenomatous Polyposis Coli
(genetics, surgery)
- Adolescent
- Adult
- Aged
- Anastomosis, Surgical
- Child
- Codon
- Follow-Up Studies
- Humans
- Ileum
(surgery)
- Middle Aged
- Mutation
- Netherlands
- Proctocolectomy, Restorative
- Rectal Neoplasms
(etiology)
- Rectum
(surgery)
- Registries
- Reoperation
- Risk Factors
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