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. 2020 Nov 18;12(11):3419.
doi: 10.3390/cancers12113419.

Assessing Effectiveness of Colonic and Gynecological Risk Reducing Surgery in Lynch Syndrome Individuals

Nuria Dueñas  1   2 , Matilde Navarro  1   2   3 , Àlex Teulé  1 , Ares Solanes  3 , Mònica Salinas  1   2 , Sílvia Iglesias  1   2 , Elisabet Munté  1 , Jordi Ponce  4 , Jordi Guardiola  5 , Esther Kreisler  6 , Elvira Carballas  7 , Marta Cuadrado  8 , Xavier Matias-Guiu  9 , Napoleón de la Ossa  10   11 , Joan Lop  12 , Conxi Lázaro  1   2 , Gabriel Capellá  1   2 , Marta Pineda  1   2 , Joan Brunet  1   2   13
Affiliations

Assessing Effectiveness of Colonic and Gynecological Risk Reducing Surgery in Lynch Syndrome Individuals

Nuria Dueñas et al. Cancers (Basel). .

Erratum in

Abstract

Background: Colorectal (CRC) and endometrial cancer (EC) are the most common types of cancer in Lynch syndrome (LS). Risk reducing surgeries (RRS) might impact cancer incidence and mortality. Our objectives were to evaluate cumulative incidences of CRC, gynecological cancer and all-cause mortality after RRS in LS individuals.

Methods: Retrospective analysis of 976 LS carriers from a single-institution registry. Primary endpoints were cumulative incidence at 75 years of cancer (metachronous CRC in 425 individuals; EC and ovarian cancer (OC) in 531 individuals) and all-cause mortality cumulative incidence, comparing extended (ES) vs. segmental surgery (SS) in the CRC cohort and risk reducing gynecological surgery (RRGS) vs. surveillance in the gynecological cohort.

Results: Cumulative incidence at 75 years of metachronous CRC was 12.5% vs. 44.7% (p = 0.04) and all-cause mortality cumulative incidence was 38.6% vs. 55.3% (p = 0.31), for ES and SS, respectively. Cumulative, incidence at 75 years was 11.2% vs. 46.3% for EC (p = 0.001) and 0% vs. 12.7% for OC (p N/A) and all-cause mortality cumulative incidence was 0% vs. 52.7% (p N/A), for RRGS vs. surveillance, respectively.

Conclusions: RRS in LS reduces the incidence of metachronous CRC and gynecological neoplasms, also indicating a reduction in all-cause mortality cumulative incidence in females undergoing RRGS.

Keywords: Lynch syndrome; colorectal neoplasms; endometrial neoplasms; gynecological neoplasms; ovarian neoplasms; prophylactic surgical procedures; risk reducing surgery; risk reduction.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Colorectal cancer cohort: (A) Cumulative incidence at 75 years of metachronous colorectal cancer in Lynch syndrome subjects comparing extended surgery and segmental surgery: Cumulative incidence at 75 years of metachronous colorectal cancer was 12.5% for extended surgery vs. 37.3% for segmental surgery (p = 0.004); (B) All-cause mortality cumulative incidence in Lynch syndrome subjects comparing extended surgery and segmental surgery: All-cause mortality cumulative incidence was 38.6% for extended surgery vs. 55.3% for segmental surgery (p = 0.31).
Figure 2
Figure 2
Cumulative incidence at 75 years of gynecological cancer in females with Lynch syndrome comparing risk reducing gynecological surgery and non-risk reducing gynecological surgery: (A) Cumulative incidence at 75 years of endometrial cancer. Cumulative incidence at 75 years of endometrial cancer was 11.2% for risk reducing gynecological surgery vs. 46.3% for non-risk reducing gynecological surgery (p = 0.001); (B) Cumulative incidence at 75 years of ovarian cancer. Cumulative incidence at 75 years of ovarian cancer was 0.0% for risk reducing gynecological surgery vs. 12.7% for non-risk reducing gynecological surgery (p = not assessable).
Figure 3
Figure 3
All-cause mortality cumulative incidence in females with Lynch syndrome comparing risk reducing gynecological surgery and non-risk reducing gynecological surgery: All-cause mortality cumulative incidence was 0.0% for 52.7% for risk reducing gynecological surgery vs. 52.7% for non-risk reducing gynecological surgery (p = not assessable).
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