Characteristics and Clinical Outcomes of Duodenal Neoplasia in Japanese Patients With Familial Adenomatous Polyposis

( Max 2000 Items )
URI http://shark.lib.kagawa-u.ac.jp/kuir/metadata/27871
Title
Characteristics and Clinical Outcomes of Duodenal Neoplasia in Japanese Patients With Familial Adenomatous Polyposis
File
Description

Abstract
BACKGROUND:

After colorectal cancer and desmoid tumors, duodenal adenocarcinoma is the next leading cause of death in familial adenomatous polyposis (FAP) patients, but it has not been thoroughly investigated.
PATIENTS AND METHODS:

To investigate the clinical course of duodenal neoplasia, including adenoma and cancer, we investigated 77 Japanese FAP patients treated at the National Cancer Center Hospital, Tokyo, Japan. We evaluated the clinicopathologic features, Spigelman severity score, and management of duodenal neoplasms. Data were acquired from a prospectively enrolled database.
RESULTS:

Fifty-one (66%) of the 77 FAP patients had duodenal neoplasia during this observational period, and 47 of 51 patients had extra-ampulla duodenal neoplasia; 42 (58%) had duodenal neoplasms (extra-ampulla), 4 had duodenal adenomas with high-grade dysplasia (HGD), and 1 had invasive carcinoma. Among the 45 patients (extra-ampulla) with duodenal adenoma with HGD or low-grade dysplasia, 8 (18%) patients were treated using endoscopic resection (ER). During the short observation period, ER was performed only in HGD cases. None of the patients died from duodenal neoplasia. In total, during the surveillance period, duodenal HGD was detected in 5 (63%) of 8 patients graded as Spigelman stage IV; HGD was not detected in stage 0 (n=33), I (n=0), II (n=12), or III (n=20) patients.
CONCLUSIONS:

Short-interval endoscopic surveillance and appropriate ER may help prevent duodenal invasive carcinoma. In addition, there was little development of invasive carcinoma during the follow-up. The Spigelman classification is beneficial for the risk assessment of duodenal neoplasia in Japanese FAP patients.

(医博甲647)

Author
著者 谷内田 達夫
著者(ヨミ) ヤチダ タツオ
著者(別表記) Yachida Tatsuo
Publication Title
Journal of Clinical Gastroenterology
Publication Title Alternative
J Clin Gastroenterol.
Volume
51
Issue
5
Start Page
407
End Page
411
Publisher
World Gastroenterology Organisation
World Organization for Specialized Studies on Diseases of the Esophagus
Lippincott, Williams & Wilkins
Published Date
2017-05-01
ISSN
0192-0790
NCID
AA00257261
PMID
27306941
DOI
10.1097/MCG.0000000000000555
Resource Type
Thesis or Dissertation
Language
eng
Resource URL
https://doi.org/10.1097/MCG.0000000000000555
Relation(isVersionOf)
Publisher's Version.
Rights
DOI: https://doi.org/10.1097/MCG.0000000000000555
Text Version
ETD
Grant ID
博甲第647号
Grant Date
2016-09-29
Degree Name
博士(医学)
Grantor
香川大学
Set
香川大学
Copyright (C) 2009 Kagawa University All rights reserved.