DCLK1 Expression in Colorectal Polyps Increases with the Severity
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Practice Parameters for the Treatment of Patients with Dominantly Inherited Colorectal Cancer
Practice Parameters For The Treatment Of Patients With Dominantly Inherited Colorectal Cancer Diseases of the Colon & Rectum 2003;46(8):1001-1012 Prepared by: The Standards Task Force The American Society of Colon and Rectal Surgeons James Church, MD; Clifford Simmang, MD; On Behalf of the Collaborative Group of the Americas on Inherited Colorectal Cancer and the Standards Committee of the American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons is dedicated to assuring high quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The standards committee is composed of Society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This Committee was created in order to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus. This is accompanied by developing Clinical Practice Guidelines based on the best available evidence. These guidelines are inclusive, and not prescriptive. Their purpose is to provide information on which decisions can be made, rather than dictate a specific form of treatment. These guidelines are intended for the use of all practitioners, health care workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. Practice Parameters for the Treatment of Patients With Dominantly Inherited Colorectal Cancer Inherited colorectal cancer includes two main syndromes in which predisposition to the disease is based on a germline mutation that may be transmitted from parent to child. -
Genetic/Familial High-Risk Assessment: Colorectal
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Genetic/Familial High-Risk Assessment: Colorectal Version 2.2019 — August 8, 2019 NCCN.org Continue Version 2.2019, 08/08/19 © 2019 National Comprehensive Cancer Network® (NCCN®), All rights reserved. NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN. Printed by PEDRO ANTONIO PARRA BAOS on 11/18/2019 12:12:24 PM. For personal use only. Not approved for distribution. Copyright © 2019 National Comprehensive Cancer Network, Inc., All Rights Reserved. NCCN Guidelines Index NCCN Guidelines Version 2.2019 Table of Contents Genetic/Familial High-Risk Assessment: Colorectal Discussion *Dawn Provenzale, MD, MS/Chair ¤ Þ Michael J. Hall, MD, MS † ∆ Arnold J. Markowitz, MD ¤ Duke Cancer Institute Fox Chase Cancer Center Memorial Sloan Kettering Cancer Center *Samir Gupta, MD/Vice-chair ¤ Amy L. Halverson, MD ¶ Robert J. Mayer, MD † Þ UC San Diego Moores Cancer Center Robert H. Lurie Comprehensive Cancer Dana-Farber/Brigham and Women’s Center of Northwestern University Cancer Center Dennis J. Ahnen, MD ¤ University of Colorado Cancer Center Stanley R. Hamilton, MD ≠ June Mikkelson, MS, CGC ∆ The University of Texas Roswell Park Cancer Institute Lee-May Chen, MD ¶ MD Anderson Cancer Center UCSF Helen Diller Family Reid M. Ness, MD, MPH ¤ Comprehensive Cancer Center Heather Hampel, MS, CGC ∆ Vanderbilt-Ingram Cancer Center The Ohio State University Comprehensive Daniel C. Chung, MD ¤ ∆ Cancer Center - James Cancer Hospital Shajan Peter, MD ¤ Massachusetts General Hospital and Solove Research Institute O'Neal Comprehensive Cancer Center Cancer Center at UAB Sigurdis Haraldsdottir, MD, PhD † Gregory Cooper, MD ¤ Stanford Cancer Institute Scott E. -
Guidelines for the Management of Hereditary Colorectal Cancer
Guidelines Guidelines for the management of hereditary Gut: first published as 10.1136/gutjnl-2019-319915 on 28 November 2019. Downloaded from colorectal cancer from the British Society of Gastroenterology (BSG)/Association of Coloproctology of Great Britain and Ireland (ACPGBI)/ United Kingdom Cancer Genetics Group (UKCGG) Kevin J Monahan ,1,2 Nicola Bradshaw,3 Sunil Dolwani,4 Bianca Desouza,5 Malcolm G Dunlop,6 James E East,7,8 Mohammad Ilyas,9 Asha Kaur,10 Fiona Lalloo,11 Andrew Latchford,12 Matthew D Rutter ,13,14 Ian Tomlinson ,15,16 Huw J W Thomas,1,2 James Hill,11 Hereditary CRC guidelines eDelphi consensus group ► Additional material is ABSTRact having a family history of a first-degree relative published online only. To view Heritable factors account for approximately 35% of (FDR) or second degree relative (SDR) with CRC.2 please visit the journal online (http:// dx. doi. org/ 10. 1136/ colorectal cancer (CRC) risk, and almost 30% of the While highly penetrant syndromes such as Lynch gutjnl- 2019- 319915). population in the UK have a family history of CRC. syndrome (LS), familial adenomatous polyposis (FAP) The quantification of an individual’s lifetime risk of and other polyposis syndromes account for account For numbered affiliations see end of article. gastrointestinal cancer may incorporate clinical and for only 5–10% of all CRC diagnoses, advances molecular data, and depends on accurate phenotypic in genetic diagnosis, improvements in endoscopic Correspondence to assessment and genetic diagnosis. In turn this may surgical control, and medical and lifestyle interven- Dr Kevin J Monahan, Family facilitate targeted risk-reducing interventions, including tions provide opportunities for CRC prevention and Cancer Clinic, St Mark’s endoscopic surveillance, preventative surgery and effective treatment in susceptible individuals. -
Comparing Right Colon Adenoma and Hyperplastic Polyp
Title: Comparing right colon adenoma and hyperplastic polyp miss rate in colonoscopy using water exchange and carbon dioxide insufflation: A prospective multicenter randomized controlled trial NCT Number: 03845933 Unique Protocol ID: EGH-2019 Date: Feb 16, 2019 頁 1 / 10 INTRODUCTION Colonoscopy is currently regarded as the gold standard to detect and prevent colorectal cancer (CRC) [1]. It estimated to prevent about 76%-90% of CRC [2], but post-colonoscopy CRCs (PCCRCs) still occur. Recent case-control studies consistently demonstrated that protection by colonoscopy against right-sided colon cancer, ranging from 40% to 60%, was lower than the 80% protection attained in the left colon [3-5]. Of all PCCRCs, 58% were attributed to lesions missed during examination [6]. In a systematic review of tandem colonoscopy studies, a 22% pooled miss-rate for all polyps was reported [7]. Colonoscopy maneuvers helping to reduce miss-rate for all polyps, particularly in the right colon, have the potential to decrease the incidence of PCCRCs. Water exchange (WE) colonoscopy is characterized by the gasless insertion to the cecum in clear water and maximizing cleanliness during insertion. WE colonoscopy has been shown to improve the overall adenoma detection rate (ADR), compared to air insufflation colonoscopy, in many prospective randomized controlled trials (RCTs) [8-13]. WE colonoscopy also has been shown to improve right colon ADR in RCTs [10-12] and meta-analyses [14,15]. In a pooled data from two multisite RCTs, WE also significantly increases right colon combined advanced and sessile serrated ADR as compared to air insufflation colonoscopy [16]. Decreased multitasking-related distraction from cleaning maneuvers has been the most recently identified explanation for the increase in ADR by WE [17]. -
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Inherited Polyposis Syndromes Daniel Herzig, M.D
CLINICAL PRACTICE GUIDELINES The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Inherited Polyposis Syndromes Daniel Herzig, M.D. • Karin Hardimann, M.D. • Martin Weiser, M.D. • Nancy Yu, M.D. Ian Paquette, M.D. • Daniel L. Feingold, M.D. • Scott R. Steele, M.D. Prepared by the Clinical Practice Guidelines Committee of The American Society of Colon and Rectal Surgeons he American Society of Colon and Rectal Surgeons METHODOLOGY (ASCRS) is dedicated to ensuring high-quality pa- tient care by advancing the science, prevention, and These guidelines are built on the last set of the ASCRS T Practice Parameters for the Identification and Testing of management of disorders and diseases of the colon, rectum, Patients at Risk for Dominantly Inherited Colorectal Can- and anus. The Clinical Practice Guidelines Committee is 1 composed of society members who are chosen because they cer published in 2003. An organized search of MEDLINE have demonstrated expertise in the specialty of colon and (1946 to December week 1, 2016) was performed from rectal surgery. This committee was created to lead interna- 1946 through week 4 of September 2016 (Fig. 1). Subject tional efforts in defining quality care for conditions related headings for “adenomatous polyposis coli” (4203 results) to the colon, rectum, and anus, in addition to the devel- and “intestinal polyposis” (445 results) were included, us- opment of Clinical Practice Guidelines based on the best ing focused search. The results were combined (4629 re- available evidence. These guidelines are inclusive and not sults) and limited to English language (3981 results), then prescriptive. -
Combined Endo-Laparoscopic Surgery for Difficult Benign Colorectal Polyps
485 Review Article (Current Strategies in Colon Cancer Management) Combined endo-laparoscopic surgery for difficult benign colorectal polyps Zhong-Hui Liu1, Li Jiang1, Fion Siu-Yin Chan1,2, Michael Ka-Wah Li3, Joe King-Man Fan1,2,3 1Department of Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China; 2Department of Surgery, The University of Hong Kong, Hong Kong, China; 3Asia-Pacific Endo-Lap Surgery Group (APELS), Hong Kong, China Contributions: (I) Conception and design: JKM Fan, MKW Li; (II) Administrative support: MKW Li; (III) Provision of study materials or patients: FSY Chan; (IV) Collection and assembly of data: ZH Liu, L Jiang; (V) Data analysis and interpretation: ZH Liu; FSY Chan; JKM Fan; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Joe King-Man Fan, MBBS (HK), MS (HKU), FRCSEd, FACS. Department of Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China. Email: [email protected]. Abstract: Prevention of colorectal cancer (CRC) depends largely on the detection and removal of colorectal polyps. Despite the advances in endoscopic techniques, there are still a subgroup of polyps that cannot be treated purely by endoscopic approach, which comprise of about 10–15% of all the polyps. These so-called “difficult colorectal polyps” are polyps with large size, morphology, at difficult location, scarring or due to recurrence, which have historically been managed by surgical segmental resection. In treating benign difficult colorectal polyps, we have to balance the operative risks and morbidities associated with surgical segmental resection. Therefore, combined endoscopic and laparoscopic surgery (CELS) has been developed to remove this subgroup of difficult benign polyps. -
Familial Adenomatous Polyposis Polymnia Galiatsatos, M.D., F.R.C.P.(C),1 and William D
American Journal of Gastroenterology ISSN 0002-9270 C 2006 by Am. Coll. of Gastroenterology doi: 10.1111/j.1572-0241.2006.00375.x Published by Blackwell Publishing CME Familial Adenomatous Polyposis Polymnia Galiatsatos, M.D., F.R.C.P.(C),1 and William D. Foulkes, M.B., Ph.D.2 1Division of Gastroenterology, Department of Medicine, The Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal, Quebec, Canada, and 2Program in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University, Montreal, Quebec, Canada Familial adenomatous polyposis (FAP) is an autosomal-dominant colorectal cancer syndrome, caused by a germline mutation in the adenomatous polyposis coli (APC) gene, on chromosome 5q21. It is characterized by hundreds of adenomatous colorectal polyps, with an almost inevitable progression to colorectal cancer at an average age of 35 to 40 yr. Associated features include upper gastrointestinal tract polyps, congenital hypertrophy of the retinal pigment epithelium, desmoid tumors, and other extracolonic malignancies. Gardner syndrome is more of a historical subdivision of FAP, characterized by osteomas, dental anomalies, epidermal cysts, and soft tissue tumors. Other specified variants include Turcot syndrome (associated with central nervous system malignancies) and hereditary desmoid disease. Several genotype–phenotype correlations have been observed. Attenuated FAP is a phenotypically distinct entity, presenting with fewer than 100 adenomas. Multiple colorectal adenomas can also be caused by mutations in the human MutY homologue (MYH) gene, in an autosomal recessive condition referred to as MYH associated polyposis (MAP). Endoscopic screening of FAP probands and relatives is advocated as early as the ages of 10–12 yr, with the objective of reducing the occurrence of colorectal cancer. -
3. Studies of Colorectal Cancer Screening
IARC HANDBOOKS COLORECTAL CANCER SCREENING VOLUME 17 This publication represents the views and expert opinions of an IARC Working Group on the Evaluation of Cancer-Preventive Strategies, which met in Lyon, 14–21 November 2017 LYON, FRANCE - 2019 IARC HANDBOOKS OF CANCER PREVENTION 3. STUDIES OF COLORECTAL CANCER SCREENING 3.1 Methodological considerations end-point of the RCT can be the incidence of the cancer of interest. Methods for colorectal cancer (CRC) screen- The observed effect of screening in RCTs is ing include endoscopic methods and stool-based dependent on, among other things, the partic- tests for blood. The two primary end-points for ipation in the intervention group and the limi- endoscopic CRC screening are (i) finding cancer tation of contamination of the control group. at an early stage (secondary prevention) and Low participation biases the estimate of effect (ii) finding and removing precancerous lesions towards its no-effect value, and therefore it must (adenomatous polyps), to reduce the incidence be evaluated and reported. Screening of controls of CRC (primary prevention). The primary by services outside of the RCT also dilutes the end-point for stool-based tests is finding cancer effect of screening on CRC incidence and/or at an early stage. Stool-based tests also have some mortality. If the screening modality being eval- ability to detect adenomatous polyps; therefore, a uated is widely used in clinical practice in secondary end-point of these tests is reducing the the region or regions where the RCT is being incidence of CRC. conducted, then contamination may be consid- erable, although it may be difficult and/or costly 3.1.1 Randomized controlled trials of to estimate its extent. -
Molecular Classification of Patients with Unexplained Hamartomatous and Hyperplastic Polyposis
ORIGINAL CONTRIBUTION Molecular Classification of Patients With Unexplained Hamartomatous and Hyperplastic Polyposis Kevin Sweet, MS, CGC Context Significant proportions of patients with hamartomatous polyposis or with Joseph Willis, MD hyperplastic/mixed polyposis remain without specific clinical and molecular diagnosis Xiao-Ping Zhou, MD, PhD or present atypically. Assigning a syndromic diagnosis is important because it guides management, especially surveillance and prophylactic surgery. Carol Gallione, PhD Objective To systematically classify patients with unexplained hamartomatous or hy- Takeshi Sawada, MD, PhD perplastic/mixed polyposis by extensive molecular analysis in the context of central Pia Alhopuro, MD rereview of histopathology results. Sok Kean Khoo, PhD Design, Setting, and Patients Prospective, referral-based study of 49 unrelated patients from outside institutions (n=28) and at a comprehensive cancer center (n=21), Attila Patocs, MD, PhD conducted from May 2, 2002, until December 15, 2004. Germline analysis of PTEN, Cossette Martin, PhD BMPR1A, STK11 (sequence, deletion), SMAD4, and ENG (sequence), specific exon screen- Scott Bridgeman, BSc ing of BRAF, MYH, and BHD, and rereview of polyp histology results were performed. John Heinz, PhD Main Outcome Measures Molecular, clinical, and histopathological findings in pa- tients with unexplained polyposis. Robert Pilarski, MS, CGC Results Of the 49 patients, 11 (22%) had germline mutations. Of 14 patients with Rainer Lehtonen, BSc juvenile polyposis, 2 with early-onset disease had mutations in ENG, encoding endo- Thomas W. Prior, PhD glin, previously only associated with hereditary hemorrhagic telangiectasia; 1 had hemi- zygous deletion encompassing PTEN and BMPR1A; and 1 had an SMAD4 mutation. Thierry Frebourg, MD, PhD One individual previously classified with Peutz-Jeghers syndrome had a PTEN dele- Bin Tean Teh, MD, PhD tion. -
Effect Modification of Vitamin D Supplementation By
nutrients Article Effect Modification of Vitamin D Supplementation by Histopathological Characteristics on Survival of Patients with Digestive Tract Cancer: Post Hoc Analysis of the AMATERASU Randomized Clinical Trial Hideyuki Yonaga 1,2, Shinya Okada 3 , Taisuke Akutsu 1, Hironori Ohdaira 4, Yutaka Suzuki 4 and Mitsuyoshi Urashima 1,* 1 Division of Molecular Epidemiology, The Jikei University School of Medicine, 3–25–8, Nishi-Shimbashi, Minato-Ku, Tokyo 105-8461, Japan; [email protected] (H.Y.); [email protected] (T.A.) 2 Celgene K. K., JP TOWER 2–7–2 Marunouchi Chiyoda-ku, Tokyo 100-7010, Japan; [email protected] 3 Department of Pathology, International University of Health and Welfare Hospital, 537–3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan; [email protected] 4 Department of Surgery, International University of Health and Welfare Hospital, 537–3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan; [email protected] (H.O.); [email protected] (Y.S.) * Correspondence: [email protected]; Tel.: +81-3-3433-1111 (ext. 2405) Received: 13 September 2019; Accepted: 21 October 2019; Published: 22 October 2019 Abstract: Some coauthors of this study previously performed the AMATERASU randomized, double-blind, placebo-controlled trial of postoperative oral vitamin D supplementation (2000 IU/day) in 417 patients with stage I to III digestive tract cancer from the esophagus to the rectum who underwent curative surgery (UMIN000001977). We conducted a post-hoc analysis of the AMATERASU trial to explore the effects of modification of vitamin D supplementation by histopathological characteristics on survival. Among patients with poorly differentiated adenocarcinoma, the 5-year relapse-free survival rate of patients supplemented with vitamin D was 91% compared with 63% in the placebo group (hazard ratio [HR], 0.25; 95% confidence interval [CI], 0.08 to 0.78; P = 0.017; P for interaction = 0.023). -
Risk Factors Associated with Rectal Neuroendocrine Tumors: a Cross-Sectional Study
Author Manuscript Published OnlineFirst on May 9, 2014; DOI: 10.1158/1055-9965.EPI-14-0132 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. Risk Factors Associated with Rectal Neuroendocrine Tumors: A Cross-Sectional Study Yoon Suk Jung1, Kyung Eun Yun2, Yoosoo Chang2,3, Seungho Ryu2,3, Jung Ho Park1, Hong Joo Kim1, Yong Kyun Cho1, Chong Il Sohn1, Woo Kyu Jeon1, Byung Ik Kim1, and Dong Il Park1 1Department of Internal Medicine, 2Center for Cohort Studies, Total Healthcare Center, 3Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea Running title: Risk factors for rectal neuroendocrine tumors Corresponding author: Dong Il Park, MD, PhD Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine 108, Pyung-Dong, Jongro-Ku, Seoul, Korea 110-746 Phone: +82-2-2001-2059, Fax: +82-2-2001-2049 E-mail: [email protected] Disclosure of Potential Conflicts of Interest: We have nothing to disclose. 1 Downloaded from cebp.aacrjournals.org on October 1, 2021. © 2014 American Association for Cancer Research. Author Manuscript Published OnlineFirst on May 9, 2014; DOI: 10.1158/1055-9965.EPI-14-0132 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. Abstract Background: The incidence of rectal neuroendocrine tumors (NETs) has been increasing since the implementation of the screening colonoscopy. However, very little is known about risk factors associated with rectal NETs. We examined the prevalence of and the risk factors for rectal NETs in a Korean population. -
(ACRCSP) Post Polypectomy Surveillance Guidelines
Alberta Colorectal Cancer Screening Program (ACRCSP) Post Polypectomy Surveillance Guidelines June 2013 ACRCSP Post Polypectomy Surveillance Guidelines - 2 TABLE OF CONTENTS Background ………………………………………………………………………………………... 3 Terms, Definitions and Practical Points……………………………………………………….. 4 Post Colonoscopy Screening……………………………………………………………………. 5 Post Polypectomy Surveillance…………………………………………………………………..6 References ………………………………………………………………………………………….12 ACRCSP Post Polypectomy Surveillance Guidelines - 3 Background Adherence to evidence based guidelines is supported by the reduction of interval colorectal cancers and colorectal cancer (CRC)- related mortality. Surveillance interval guidelines are based on the presumption that a high quality baseline colonoscopy was performed (i.e. that the colonoscopy was completed to the cecum, and that the colonic mucosa was well visualized). It is also important to ensure the completeness of polypectomy and that all polypectomy material was sent to pathology. Patients with a failed colonoscopy (for example due to inability to reach cecum or poor bowel preparation) should undergo repeat colonoscopy (either by same operator or referred, depending on the reason why the colonoscopy was incomplete) or, less preferably, diagnostic imaging of the colon by CT colonography. A system should be in place to ensure that all pathology reports are reviewed and that recommendations to primary care physician regarding surveillance intervals are adjusted as indicated. Endoscopists should make clear recommendations to primary care physicians about the need for and timing of subsequent colonoscopy. Considering that the recommendation largely depends on the histological findings, interval recommendation in patients with polyps should account for the pathology report instead of being made at the time of colonoscopy. The decision regarding surveillance interval should be based on the most advanced finding(s) at baseline colonoscopy.