Current clinical practice for familial adenomatous polyposis in Japan: A nationwide multicenter study. Issue 6 (24th May 2022)

• Record Type: Journal Article
• Authors: Matsubara, Takaaki; Beppu, Naohito; Ikeda, Masataka; Ishida, Hideyuki; Takeuchi, Yoji; Nagasaki, Toshiya; Takao, Akinari; Sasaki, Kazuhito; Akagi, Kiwamu; Sudo, Tomoya; Ueno, Hideki; Yamaguchi, Tatsuro; Tomita, Naohiro; Ajioka, Yoichi
• Is Part Of: Annals of gastroenterological surgery. Volume 6:Issue 6(2022)
• Page Start: 778
• Page End: 787
• Publication Date: 2022-05-24
• Subjects: colorectal cancer -- desmoid tumors -- familial adenomatous polyposis -- non‐colectomy; Digestive organs -- Surgery -- Periodicals; 617.43
• DOI: 10.1002/ags3.12577
• Languages: English
• ISSNs: 2475-0328

Abstract

Abstract: Introduction: In Japanese patients with familial adenomatous polyposis (FAP), colectomy tends to be postponed or avoided. Aim: This study aimed to clarify the current clinical practice from a Japanese multicenter cohort study database. Methods: We analyzed the records of 250 patients with non‐dense FAP who did not require colorectal cancer removal. The clinical outcomes were compared between patients who received colectomy (n = 142) (Group A) and those who did not receive colectomy (n = 108) (Group B). Results: The colectomy rate based on the age at the final follow‐up examination was 46%, 60%, 54%, 65%, at ≤29, 30–39, 40–49, and ≥ 50 years, respectively ( P = .11). The development of colorectal cancer did not differ between Groups A and B (25% vs 22% P = .67); however, colorectal cancer was diagnosed at the Tis stage in 88% of the patients with colorectal cancer in Group B, and 34% of the patients with colorectal cancer in Group A ( P < .01). Regarding survival, all patients in Group B were alive at the final follow‐up examination. In contrast, six patients in Group A died, including three patients with desmoid tumors and one with colon cancer. Conclusion: Over one‐third of patients with non‐dense FAP (polyps ≤ 1000) in Japan did not receive colectomy at >30 years of age, and patients who managed without colectomy showed acceptable survival with the early diagnosis of colorectal cancer, and a very low incidence of desmoid tumor development, indicating that this approach represents a potential option for the management of selected non‐dense FAP patients. Abstract : Over one‐third of patients with non‐dense FAP in Japan did not receive colectomy at >30 years of age, and patients managed without colectomy showed acceptable survival with the early diagnosis of colorectal cancer, and a very low incidence of desmoid tumor development, indicating that this approach represents a potential option for the management of selected non‐dense FAP patients.