Surveillance improves survival of colorectal cancer in patients with hereditary nonpolyposis colorectal cancer.

Cancer detection and prevention Pub Date : 2000-01-01
L Renkonen-Sinisalo, M Aarnio, J P Mecklin, H J Järvinen
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Abstract

Some patients with the hereditary nonpolyposis colorectal cancer (HNPCC) syndrome develop carcinoma despite surveillance. The aim of this study was to determine whether survival was greater in colorectal cancer (CRC) cases detected by surveillance than in patients who had disease diagnosed on the basis of symptoms. All 150 CRC cases detected in 57 HNPCC families over the last 15 years were divided into two groups depending on whether they had been included in the surveillance program (n = 35) or not (n = 115). The stage distribution of the tumors in the group that underwent surveillance (Dukes' A, 50%; B, 35%; C, 15%; D, 0%) was significantly more favorable (P < .001) than in the group without surveillance (Dukes' A, 17%; B, 50%; C, 16%; D, 17%). CRC-specific 10-year survival was 93% in the surveillance group, significantly better than the 68% in the nonsurveillance group (P < .02). The overall survival did not differ significantly between the two groups despite a tendency in favor of the surveillance group. Colonoscopic surveillance enables early detection of CRC in HNPCC and reduces CRC mortality.

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监测可提高遗传性非息肉病性结直肠癌患者的生存率。
一些遗传性非息肉病性结直肠癌(HNPCC)综合征的患者在监测后仍发生癌。本研究的目的是确定通过监测检测到的结直肠癌(CRC)患者的生存率是否高于根据症状诊断出疾病的患者。根据是否纳入监测项目(n = 35) (n = 115),将过去15年在57个HNPCC家庭中发现的所有150例结直肠癌病例分为两组。观察组肿瘤分期分布(Dukes' A, 50%;B, 35%;C, 15%;D, 0%)显著优于无监护组(Dukes' A, 17%;B, 50%;C, 16%;D, 17%)。监测组crc特异性10年生存率为93%,显著优于非监测组的68% (P < 0.02)。两组患者的总体生存率没有显著差异,尽管监测组的生存率更高。结肠镜监测能够在HNPCC中早期发现结直肠癌并降低结直肠癌死亡率。
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