Surgical management of hereditary colorectal cancer: surgery based on molecular analysis and family history.
The importance of colorectal cancer (CRC) is increasing. A proportion show a hereditary component, as in Lynch syndrome and Familial Adenomatous Polyposis, and a recently defined entity as well, namely, Familial Colorectal Cancer type X. The high probability to develop CRC in these groups may, at the time of recognition, change surgical management, including its timing or even the surgical technique. In some cases prophylactic surgery can play an important role. The possibility of using tools that allow recognition of the aforementioned syndromes, including microsatellite instability, immunohistochemistry for DNA mismatch repair system proteins, and especially their mutations, is on the basis of therapeutic strategies that differ from those employed in sporadic CRC cases.
Department of General Surgery B, "12 de Octubre" University Hospital, Madrid, Spain. josepereag@hotmail.com
J
J
Perea
I
I
Justo
E
E
Alvaro
M
M
Lomas
J Díaz
JD
Tasende
J C
JC
Marín
A
A
Franco
F
F
Colina
Y
Y
Rodríguez
J
J
Martínez
L
L
Robles
M
M
Urioste
M
M
Hidalgo
D011125:Adenomatous Polyposis Coli / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D003082:Colectomy; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000601:surgery*; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000175:diagnosis / Q000235:genetics* / Q000601:surgery*; D053843:DNA Mismatch Repair; D005260:Female; D005817:Genetic Counseling; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D053842:Microsatellite Instability; D009154:Mutation; D010375:Pedigree; D016737:Proctocolectomy, Restorative