| Theme |
Lynch Syndrome and Hereditary Polyposis Syndromes |
| Title |
Clinical Practice for Lynch Syndrome from Surgical Points of View |
| Author |
Hideyuki Ishida |
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author |
Noriyasu Chika |
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author |
Tetsuya Ito |
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author |
Azusa Yamamoto |
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author |
Okihide Suzuki |
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author |
Keiichiro Ishibashi |
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| [ Summary ] |
The cumulative risk of colorectal cancer (CRC) in patients with Lynch syndrome (LS) ranges between 10 % and 46 % by the age of 70 years, depending on the affected gene. Despite the high cumulative risk of metachronous CRC after surgery for the first CRC, the optimal surgical treatment for patients with LS is controversial. Prophylactic colorectal resection prior to CRC development is not recommended regardless of the type of surgery performed. Recent studies have shown that the risk of metachronous CRC is significantly higher following segmental colectomy than after extended colectomy in patients with genetically proven LS. However, overall survival was not different between patients undergoing the aforementioned surgical procedures. The choice of an optimal surgical procedure to treat the first rectal cancer is difficult owing to lack of available data. The choice of the surgical procedure for first CRC in patients with LS depends upon several factors that may vary among patients, including the time of diagnostic genetic testing (before or after the development of first CRC), age at the time of CRC diagnosis, location of CRC, the affected genes, and the expected quality of life. Individuals with genetically proven LS require counseling prior to any surgical intervention for first CRC. |