Imperial College London
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Dr Mark P. Lythgoe

Faculty of Medicine, Department of Surgery & Cancer

Research Postgraduate
 
 
 
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Contact

 

m.lythgoe

 
 
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Location

 

Institute of Reproductive and Developmental BiologyHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Malik:2018:10.1007/s10689-017-0062-2,
author = {Malik, SS and Lythgoe, MP and McPhail, M and Monahan, KJ},
doi = {10.1007/s10689-017-0062-2},
journal = {Familial Cancer},
pages = {557--564},
title = {Metachronous colorectal cancer following segmental or extended colectomy in Lynch syndrome: a systematic review and meta-analysis},
url = {http://dx.doi.org/10.1007/s10689-017-0062-2},
volume = {17},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Around 5% of colorectal cancers are due to mutations within DNA mismatch repair genes, resulting in Lynch syndrome (LS). These mutations have a high penetrance with early onset of colorectal cancer at a mean age of 45 years. The mainstay of surgical management is either a segmental or extensive colectomy. Currently there is no unified agreement as to which management strategy is superior due to limited conclusive empirical evidence available. A systematic review and meta- analysis to evaluate the risk of metachronous colorectal cancer (MCC) and mortality in LS following segmental and extensive colectomy. A systematic review of the PubMed database was conducted. Studies were included/ excluded based on pre-specified criteria. To assess the risk of MCC and mortality attributed to segmental or extensive colectomies, relative risks (RR) were calculated and corresponding 95% confidence intervals (CI). Publication bias was investigated using funnel plots. Data about mortality, as well as patient ascertainment [Amsterdam criteria (AC), germline mutation (GM)] were also extracted. Statistical analysis was conducted using the R program (version 3.2.3). The literature search identified 85 studies. After further analysis ten studies were eligible for inclusion in data synthesis. Pooled data identified 1389 patients followed up for a mean of 100.7 months with a mean age of onset of 45.5 years of age. A total 1119 patients underwent segmental colectomies with an absolute risk of MCC in this group of 22.4% at the end of follow-up. The 270 patients who had extensive colectomies had a MCC absolute risk of 4.7% (0% in those with a panproctocolecomy). Segmental colectomy was significantly associated with an increased relative risk of MCC (RR = 5.12; 95% CI 2.88–9.11; Fig. 1), although no significant association with mortality was identified (RR = 1.65; 95% CI 0.90–3.02). There was no statistically significant difference in the risk of MCC betwe
AU  - Malik,SS
AU  - Lythgoe,MP
AU  - McPhail,M
AU  - Monahan,KJ
DO  - 10.1007/s10689-017-0062-2
EP  - 564
PY  - 2018///
SN  - 1389-9600
SP  - 557
TI  - Metachronous colorectal cancer following segmental or extended colectomy in Lynch syndrome: a systematic review and meta-analysis
T2  - Familial Cancer
UR  - http://dx.doi.org/10.1007/s10689-017-0062-2
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000445753400011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/68237
VL  - 17
ER  -
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