[Preventive therapy of HNPCC--a study concept].
Due to different pattern of penetrance and heterogeneity, the role of prophylactic surgery must be individually defined for every hereditary cancer predisposition. For HNPCC (hereditary nonpolyposis colorectal cancer) subtotal colectomy at the time of colorectal cancer diagnosis is being recommended by the Cancer Genetics Studies Consortium Recent Guidelines from the DGVS (Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten) state that to date no general recommendation favouring this approach can be made. The open question is: how effective is segmental resection and endoscopic surveillance in given time intervals compared with the reduction of risk by performing extended (prophylactic) surgery. Also the issue of dealing with rectal cancer as the first primary in HNPCC patients must be addressed. In order to answer these questions and after the lessons learned from BRCA mutation carriers and prophylactic mastectomies, quality of life measurement is mandatory for this study.
Möslein
G
G
Chirurgische Klinik A, Heinrich-Heine-Universität, Moorenstrasse 5, 40225 Düsseldorf.
Albrecht
J
J
Ohmann
C
C
Schackert
H K
HK
D003082:Colectomy; D003113:Colonoscopy; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000175:diagnosis / Q000235:genetics / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D017410:Practice Guidelines as Topic; D016737:Proctocolectomy, Restorative; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate