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RESEARCH PRODUCT
Survival by colon cancer stage and screening interval in Lynch syndrome:a prospective Lynch syndrome database report
Toni T. SeppäläToni T. SeppäläSigve NakkenFiona LallooJoan VidalEivind HovigEivind HovigIngrid WinshipIngrid WinshipRodney J. ScottKarina RønlundMagnus Von Knebel DoeberitzMagnus Von Knebel DoeberitzJulian R. SampsonLior H. KatzInge BernsteinMatthias KloorMatthias KloorKirsi PylvänäinenGabriela MösleinKate GreenMarta PinedaFinlay A. MacraeFinlay A. MacraeJohn BurnNoralane M. LindorHuw ThomasPål MøllerLaura Renkonen-sinisaloLaura Renkonen-sinisaloMette Karen YilmazEmma J CrosbieAnna LepistöAnna LepistöLouise Laurberg ElvangAysel AhadovaAysel AhadovaJukka-pekka MecklinGabriel CapelláMev Dominguez-valentinJohn-paul PlazzerVerena Steinke-langeJames HillAnnika LindblomSanne W. Ten BroekeD. Gareth EvansRandi Thyregaard NielsenLone SundeDouglas TjandraMaartje NielsenElke Holinski-federMatilde Navarrosubject
koloskopialcsh:QH426-470SurvivalColorectal cancer3122 CancersCancer stageColonoscopycomputer.software_genreMLH1lcsh:RC254-28203 medical and health sciences0302 clinical medicineCàncer colorectalmedicineColon cancer.Stage (cooking)Lynchin oireyhtymäGenetics (clinical)paksusuolisyöpäSurveillanceDatabasemedicine.diagnostic_testbusiness.industryResearchCancerColonoscòpiaColonoscopymedicine.diseaselcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogensColorectal cancerLynch syndromedigestive system diseases3. Good healthColon cancerMSH6lcsh:GeneticsLynch syndromeOncologyMSH2030220 oncology & carcinogenesis030211 gastroenterology & hepatologybusinesshenkiinjääminencomputerdescription
Abstract Background We previously reported that in pathogenic mismatch repair (path_MMR) variant carriers, the incidence of colorectal cancer (CRC) was not reduced when colonoscopy was undertaken more frequently than once every 3 years, and that CRC stage and interval since last colonoscopy were not correlated. Methods The Prospective Lynch Syndrome Database (PLSD) that records outcomes of surveillance was examined to determine survival after colon cancer in relation to the time since previous colonoscopy and pathological stage. Only path_MMR variants scored by the InSiGHT variant database as class 4 or 5 (clinically actionable) were included in the analysis. Results Ninety-nine path_MMR carriers had no cancer prior to or at first colonoscopy, but subsequently developed colon cancer. Among these, 96 were 65 years of age or younger at diagnosis, and included 77 path_MLH1, 17 path_MSH2, and 2 path_MSH6 carriers. The number of cancers detected within < 1.5, 1.5–2.5, 2.5–3.5 and at > 3.5 years after previous colonoscopy were 9, 43, 31 and 13, respectively. Of these, 2, 8, 4 and 3 were stage III, respectively, and only one stage IV (interval 2.5–3.5 years) disease. Ten-year crude survival after colon cancer were 93, 94 and 82% for stage I, II and III disease, respectively (p < 0.001). Ten-year crude survival when the last colonoscopy had been < 1.5, 1.5–2.5, 2.5–3.5 or > 3.5 years before diagnosis, was 89, 90, 90 and 92%, respectively (p = 0.91). Conclusions In path_MLH1 and path_MSH2 carriers, more advanced colon cancer stage was associated with poorer survival, whereas time since previous colonoscopy was not. Although the numbers are limited, together with our previously reported findings, these results may be in conflict with the view that follow-up of path_MMR variant carriers with colonoscopy intervals of less than 3 years provides significant benefit.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-10-14 |