■在日本家族性腺瘤性息肉病(FAP)患者中,结肠切除术往往被推迟或避免。
■本研究旨在从日本多中心队列研究数据库中阐明当前的临床实践。
■我们分析了250例不需要切除结直肠癌的非致密FAP患者的记录。比较接受结肠切除术的患者(n=142)(A组)和未接受结肠切除术的患者(n=108)(B组)的临床结果。
■最终随访检查时基于年龄的结肠切除率为46%,60%,54%,65%,在≤29、30-39、40-49和≥50岁时,分别(P=.11)。A组和B组之间结直肠癌的发展没有差异(25%vs22%P=.67);然而,在B组中,88%的结直肠癌患者在Tis阶段被诊断为结直肠癌,A组中有34%的结直肠癌患者(P<0.01)。关于生存,B组的所有患者在最后一次随访检查时均存活.相比之下,A组6名患者死亡,包括3例纤维瘤和1例结肠癌。
■在日本,超过三分之一的非致密FAP(息肉≤1000)患者在30岁以上没有接受结肠切除术,未进行结肠切除术的患者在早期诊断为结直肠癌时表现出可接受的生存率,纤维瘤的发病率非常低,表明该方法代表了管理选定的非密集FAP患者的潜在选择。
UNASSIGNED: In Japanese patients with familial adenomatous polyposis (FAP), colectomy tends to be postponed or avoided.
UNASSIGNED: This
study aimed to clarify the current clinical practice from a Japanese multicenter cohort
study database.
UNASSIGNED: We analyzed the records of 250 patients with non-dense FAP who did not require colorectal cancer removal. The clinical outcomes were compared between patients who received colectomy (n = 142) (Group A) and those who did not receive colectomy (n = 108) (Group B).
UNASSIGNED: The colectomy rate based on the age at the final follow-up examination was 46%, 60%, 54%, 65%, at ≤29, 30-39, 40-49, and ≥ 50 years, respectively (P = .11). The development of colorectal cancer did not differ between Groups A and B (25% vs 22% P = .67); however, colorectal cancer was diagnosed at the Tis stage in 88% of the patients with colorectal cancer in Group B, and 34% of the patients with colorectal cancer in Group A (P < .01). Regarding survival, all patients in Group B were alive at the final follow-up examination. In contrast, six patients in Group A died, including three patients with desmoid tumors and one with colon cancer.
UNASSIGNED: Over one-third of patients with non-dense FAP (polyps ≤ 1000) in Japan did not receive colectomy at >30 years of age, and patients who managed without colectomy showed acceptable survival with the early diagnosis of colorectal cancer, and a very low incidence of desmoid tumor development, indicating that this approach represents a potential option for the management of selected non-dense FAP patients.