Prevalence and Management of Cancer of the Rectal Stump After Total Colectomy and Rectal Sparing in Patients with Familial Polyposis: Results from a Registry-Based Study

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2022 Jan 21

PMID 35053462

Authors

Gaia Colletti

Chiara Maura Ciniselli

Stefano Signoroni

Ivana Maria Francesca Cocco

Andrea Magarotto

Maria Teresa Ricci

Clorinda Brignola

Clara Bagatin

Laura Cattaneo

Andrea Mancini

Federica Cavalcoli

Massimo Milione

Paolo Verderio

Marco Vitellaro

Affiliations

Soon will be listed here.

Abstract

Background: The balance between quality of life and colorectal cancer risk in familial adenomatous polyposis (FAP) patients is of primary importance. A cut-off of less than 30 polyps under 1 cm of diameter in the rectum has been used as an indication for performing ileo-rectal anastomosis (IRA) in terms of lower rectal cancer risk. This study aimed to assess clinical and surgical features of FAP patients who developed cancer of the rectal stump.

Methods: This retrospective study included all FAP patients who underwent total colectomy/IRA from 1977 to 2021 and developed subsequent rectal cancer. Patients' features were reported using descriptive statistics by considering the overall case series and within pre-specified classes of age (<20, 20-30, and >30 years) at first surgery.

Results: Among the 715 FAP patients, 47 (6.57%, 95% confidence interval: 4.87; 8.65) developed cancer in the rectal stump during follow-up. In total, 57.45% of the population were male and 38.30% were proband. The median interval between surgery and the occurrence of rectal cancer was 13 years. This interval was wider in the youngest group (-value: 0.012) than the oldest ones. Twelve patients (25.53%) received an endoscopic or minimally invasive resection. Amongst them, 61.70% were Dukes stage A cancers.

Conclusions: There is a definite risk of rectal cancer after total colectomy/IRA; however, the time interval from the index procedure to cancer developing is long. Minimally invasive and endoscopic treatments should be the procedures of choice in patients with early stage cancers.

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Reply to Serrano et al. Comment on "Colletti et al. Prevalence and Management of Cancer of the Rectal Stump after Total Colectomy and Rectal Sparing in Patients with Familial Polyposis: Results from a Registry-Based Study. 2022, , 298".

Colletti G, Ciniselli C, Rausa E, Signoroni S, Cocco I, Magarotto A Cancers (Basel). 2022; 14(13).

PMID: 35805013 PMC: 9265077. DOI: 10.3390/cancers14133241.

Comment on Colletti et al. Prevalence and Management of Cancer of the Rectal Stump after Total Colectomy and Rectal Sparing in Patients with Familial Polyposis: Results from a Registry-Based Study. 2022, , 298.

Serrano D, Feroce I, Bonanni B, Bertario L Cancers (Basel). 2022; 14(11).

PMID: 35681630 PMC: 9179353. DOI: 10.3390/cancers14112650.

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