title: [Strategy for surgery in familial adenomatous polyposis patients with invasive colorectal cancer].
abstract: OBJECTIVE
  Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) has been established as the standard operative procedure for classic familial adenomatous polyposis( FAP). However, it is unclear which type of surgery should be undertaken for FAP patients with invasive colorectal cancer in clinical practice. This study evaluated the outcome of different surgeries performed in FAP patients with invasive colorectal cancer.
  
  
  METHODS
  The study included 21 classic FAP patients with or without invasive colorectal cancer, who underwent proctocolectomy at our institute between 2000 and 2013. Patient background, type of operation, and prognosis were retrospectively examined.
  
  
  RESULTS
  In the non-invasive cancer group, total proctocolectomy with IPAA was performed in 7 patients, and colectomy with ileorectal anastomosis (IRA) was performed in 5 patients. Conversely, in the invasive cancer group, IPAA, proctocolectomy with end ileostomy (TPC), and IRA were performed in 2, 2, and 5 patients, respectively. Overall survival did not differ significantly between the 2 groups( 5 year survival, 88.9% vs 75.0%, p=0.48).
  
  
  CONCLUSIONS
  These results suggest that IPAA, IRA, or TPC might contribute to survival time prolongation in patients with invasive colorectal cancer, as is the case for those without invasive colorectal cancer.
authors.affiliation: Dept. of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University.
authors.forename: Takeaki
authors.initials: T
authors.lastname: Matsuzawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hatano
authors.forename: Toru
authors.initials: T
authors.lastname: Ishiguro
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kumamoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Baba
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kumagai
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Ikuya
authors.initials: I
authors.lastname: Takeuchi
authors.forename: Shigehisa
authors.initials: S
authors.lastname: Inokuma
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ishida
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult