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Correction published on 22 June 2021, see Cancers 2021, 13(13), 3104.
Article

Assessing Effectiveness of Colonic and Gynecological Risk Reducing Surgery in Lynch Syndrome Individuals

1
Hereditary Cancer Program, Catalan Institute of Oncology-IDIBELL, ONCOBELL, Hospitalet de Llobregat, 08908 Barcelona, Spain
2
Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Salud Carlos III, 28029 Madrid, Spain
3
Hereditary Cancer Program, Catalan Institute of Oncology, 08916 Badalona, Barcelona, Spain
4
Department of Gynecology, Bellvitge University Hospital, Hospitalet de Llobregat, 08908 Barcelona, Spain
5
Department of Gastroenterology, Bellvitge University Hospital, Hospitalet de Llobregat, 08908 Barcelona, Spain
6
Department of General Surgery, Bellvitge University Hospital, Hospitalet de Llobregat, 08908 Barcelona, Spain
7
Department of Gynecology, Trias i Pujol University Hospital, 08916 Badalona, Barcelona, Spain
8
Department of General Surgery, Trias i Pujol University Hospital, 08916 Badalona, Barcelona, Spain
9
Department of Pathology, Bellvitge University Hospital, Hospitalet de Llobregat, 08908 Barcelona, Spain
10
Department of Pathology, Trias i Pujol University Hospital, 08916 Badalona, Barcelona, Spain
11
Department of Pathology, Hospital General de Catalunya—Grupo Quironsalud, 08203 Barcelona, Spain
12
Department of Pathology, Hospital del Mar Institute for Medical Research, 08003 Barcelona, Spain
13
Hereditary Cancer Program, Catalan Institute of Oncology-IDBIGI, 17007 Girona, Spain
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
These authors contributed equally to this work.
Cancers 2020, 12(11), 3419; https://doi.org/10.3390/cancers12113419
Received: 14 October 2020 / Revised: 6 November 2020 / Accepted: 16 November 2020 / Published: 18 November 2020
(This article belongs to the Section Cancer Epidemiology and Prevention)
Colorectal and endometrial cancers are the most important life-threating risk in Lynch syndrome subjects, with incidences at 75 years as high as 40–60%. However, surveillance has shown to be ineffective. Risk reducing surgeries are an option in Lynch Syndrome (LS) individuals to decrease incidence of this type of cancers. In this manuscript, we have analyzed the rates of colorectal and gynecological cancer in 976 LS individuals after a mean follow-up of 10.2 years (patients under regular surveillance or after a risk reducing surgery). We can confirm in the largest study published up to the present in a single-institution that risk reducing surgeries are effective in decreasing incidence of colorectal and gynecological cancer in all LS carriers. Moreover, is the first report showing a decrease in all-cause mortality cumulative incidence in females with Lynch syndrome that undergo gynecological risk reducing surgery.
Background: Colorectal (CRC) and endometrial cancer (EC) are the most common types of cancer in Lynch syndrome (LS). Risk reducing surgeries (RRS) might impact cancer incidence and mortality. Our objectives were to evaluate cumulative incidences of CRC, gynecological cancer and all-cause mortality after RRS in LS individuals. Methods: Retrospective analysis of 976 LS carriers from a single-institution registry. Primary endpoints were cumulative incidence at 75 years of cancer (metachronous CRC in 425 individuals; EC and ovarian cancer (OC) in 531 individuals) and all-cause mortality cumulative incidence, comparing extended (ES) vs. segmental surgery (SS) in the CRC cohort and risk reducing gynecological surgery (RRGS) vs. surveillance in the gynecological cohort. Results: Cumulative incidence at 75 years of metachronous CRC was 12.5% vs. 44.7% (p = 0.04) and all-cause mortality cumulative incidence was 38.6% vs. 55.3% (p = 0.31), for ES and SS, respectively. Cumulative, incidence at 75 years was 11.2% vs. 46.3% for EC (p = 0.001) and 0% vs. 12.7% for OC (p N/A) and all-cause mortality cumulative incidence was 0% vs. 52.7% (p N/A), for RRGS vs. surveillance, respectively. Conclusions: RRS in LS reduces the incidence of metachronous CRC and gynecological neoplasms, also indicating a reduction in all-cause mortality cumulative incidence in females undergoing RRGS. View Full-Text
Keywords: Lynch syndrome; endometrial neoplasms; colorectal neoplasms; ovarian neoplasms; prophylactic surgical procedures; risk reduction; gynecological neoplasms; risk reducing surgery Lynch syndrome; endometrial neoplasms; colorectal neoplasms; ovarian neoplasms; prophylactic surgical procedures; risk reduction; gynecological neoplasms; risk reducing surgery
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MDPI and ACS Style

Dueñas, N.; Navarro, M.; Teulé, À.; Solanes, A.; Salinas, M.; Iglesias, S.; Munté, E.; Ponce, J.; Guardiola, J.; Kreisler, E.; Carballas, E.; Cuadrado, M.; Matias-Guiu, X.; de la Ossa, N.; Lop, J.; Lázaro, C.; Capellá, G.; Pineda, M.; Brunet, J. Assessing Effectiveness of Colonic and Gynecological Risk Reducing Surgery in Lynch Syndrome Individuals. Cancers 2020, 12, 3419. https://doi.org/10.3390/cancers12113419

AMA Style

Dueñas N, Navarro M, Teulé À, Solanes A, Salinas M, Iglesias S, Munté E, Ponce J, Guardiola J, Kreisler E, Carballas E, Cuadrado M, Matias-Guiu X, de la Ossa N, Lop J, Lázaro C, Capellá G, Pineda M, Brunet J. Assessing Effectiveness of Colonic and Gynecological Risk Reducing Surgery in Lynch Syndrome Individuals. Cancers. 2020; 12(11):3419. https://doi.org/10.3390/cancers12113419

Chicago/Turabian Style

Dueñas, Nuria, Matilde Navarro, Àlex Teulé, Ares Solanes, Mònica Salinas, Sílvia Iglesias, Elisabet Munté, Jordi Ponce, Jordi Guardiola, Esther Kreisler, Elvira Carballas, Marta Cuadrado, Xavier Matias-Guiu, Napoleón de la Ossa, Joan Lop, Conxi Lázaro, Gabriel Capellá, Marta Pineda, and Joan Brunet. 2020. "Assessing Effectiveness of Colonic and Gynecological Risk Reducing Surgery in Lynch Syndrome Individuals" Cancers 12, no. 11: 3419. https://doi.org/10.3390/cancers12113419

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