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dc.contributor.authorWin, Aung Ko
dc.contributor.authorParry, Susan
dc.contributor.authorParry, Bryan
dc.contributor.authorKalady, Matthew F
dc.contributor.authorMacrae, Finlay Alistair
dc.contributor.authorAhnen, Dennis J
dc.contributor.authorYoung, Graeme Paul
dc.contributor.authorLipton, Lara
dc.contributor.authorWinship, Ingrid
dc.contributor.authorBoussioutas, Alex
dc.contributor.authorYoung, Joanne P
dc.contributor.authorBuchanan, Daniel D
dc.contributor.authorArnold, Julie
dc.contributor.authorMarchand, Loic Le
dc.contributor.authorNewcomb, Polly A
dc.contributor.authorHaile, Robert W
dc.contributor.authorLindor, Noralane M
dc.contributor.authorGallinger, Steven
dc.contributor.authorHopper, John L
dc.contributor.authorJenkins, Mark
dc.identifier.citationWin AK, Parry S, Parry B, Kalady MF, Macrae FA, Ahnen DJ, Young GP, Lipton L, Winship I, Boussioutas A, Young JP, Buchanan DD, Arnold J, Le Marchand L, Newcomb PA, Haile RW, Lindor NM, Gallinger S, Hopper JL, Jenkins MA. Risk of metachronous colon cancer following surgery for rectal cancer in mismatch repair gene mutation carriers. Annals of Surgical Oncology. 2013 Jun;20(6):1829-36.en
dc.description.abstractDespite regular surveillance colonoscopy, the metachronous colorectal cancer risk for mismatch repair (MMR) gene mutation carriers after segmental resection for colon cancer is high and total or subtotal colectomy is the preferred option. However, if the index cancer is in the rectum, management decisions are complicated by considerations of impaired bowel function. We aimed to estimate the risk of metachronous colon cancer for MMR gene mutation carriers who underwent a proctectomy for index rectal cancer. Methods This retrospective cohort study comprised 79 carriers of germline mutation in a MMR gene (18 MLH1, 55 MSH2, 4 MSH6, and 2 PMS2) from the Colon Cancer Family Registry who had had a proctectomy for index rectal cancer. Cumulative risks of metachronous colon cancer were calculated using the Kaplan–Meier method. Results During median 9 years (range 1–32 years) of observation since the first diagnosis of rectal cancer, 21 carriers (27 %) were diagnosed with metachronous colon cancer (incidence 24.25, 95 % confidence interval [CI] 15.81–37.19 per 1,000 person-years). Cumulative risk of metachronous colon cancer was 19 % (95 % CI 9–31 %) at 10 years, 47 (95 % CI 31–68 %) at 20 years, and 69 % (95 % CI 45–89 %) at 30 years after surgical resection. The frequency of surveillance colonoscopy was 1 colonoscopy per 1.16 years (95 % CI 1.01–1.31 years). The AJCC stages of the metachronous cancers, where available, were 72 % stage I, 22 % stage II, and 6 % stage III. Conclusions Given the high metachronous colon cancer risk for MMR gene mutation carriers diagnosed with an index rectal cancer, proctocolectomy may need to be considered.en
dc.publisherSpringer Verlagen
dc.rights© Society of Surgical Oncology 2013en
dc.subjectColon cancer
dc.subjectMMR gene mutation
dc.subjectCancer research
dc.titleRisk of Metachronous Colon Cancer Following Surgery for Rectal Cancer in Mismatch Repair Gene Mutation Carriersen
dc.rights.holderSociety of Surgical Oncologyen

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