title: Risk Factors for the Development of Desmoid Tumor After Colectomy in Patients with Familial Adenomatous Polyposis: Multicenter Retrospective Cohort Study in Japan.
abstract: BACKGROUND
  Desmoid tumor (DT) is the primary cause of death in patients with familial adenomatous polyposis (FAP) after restorative proctocolectomy. This study aimed to identify risk factors for DT in a Japanese population.
  
  
  METHODS
  Clinical data for 319 patients with FAP undergoing first colectomy from 2000 to 2012 were reviewed retrospectively.
  
  
  RESULTS
  Two hundred seventy-seven FAP patients were included in this study. Thirty-nine (14.1 %) patients developed DT. Occurrence sites were the intraperitoneal region in 25 (64.1 %) cases, intraperitoneal region and abdominal wall in three (7.7 %), and abdominal wall in nine (23.1 %). The mean period from surgery to DT development was 26.3 months (range 4-120 months). Gender (female vs. male, p = 0.03), age at surgery (>30 vs. ≤30 years, p = 0.02), purpose of surgery (prophylactic vs. cancer excision, p = 0.01), and surgical procedure (proctocolectomy [ileoanal anastomosis (IAA), ileoanal canal anastomosis (IACA), total proctocolectomy (TPC)] vs. total colectomy [ileorectal anastomosis, partial colectomy]; p = 0.03) significantly influenced the estimated cumulative risk of developing DT at 5 years after surgery. Conversely, approach (laparoscopic vs. open, p = 0.17) had no significant effect on the increased risk of DT occurrence. In multivariate analysis, female gender, with a hazard ratio of 2.2 (p = 0.02,) and proctocolectomy (IAA, IACA, TPC), with a hazard ratio of 2.2 (p = 0.03), were independent risk factors for DT incidence after colectomy.
  
  
  CONCLUSIONS
  Female gender and proctocolectomy (IAA, IACA, TPC) were independent risk factors for developing DT after colectomy in patients with FAP.
authors.affiliation: Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan. thinoi@hiroshima-u.ac.jp.
authors.forename: Takao
authors.initials: T
authors.lastname: Hinoi
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueno
authors.affiliation: Center for Minimally Invasive Surgery, Tokyo Medical and Dental University, Bunkyō, Tokyo, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Konishi
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanazawa, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Ishida
authors.affiliation: Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsk, Mie, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Kanemitsu
authors.affiliation: Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Tomita
authors.affiliation: Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Nagahide
authors.initials: N
authors.lastname: Matsubara
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Komori
authors.affiliation: Department of Surgery, Tochigi Cancer Center, Utsunomiya, Tochigi, Japan.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kotake
authors.affiliation: Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagasaka
authors.affiliation: Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Hasegawa
authors.affiliation: Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Motoi
authors.initials: M
authors.lastname: Koyama
authors.affiliation: Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
authors.affiliation: Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyō, Tokyo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Tokyo Medical and Dental University, Bunkyō, Tokyo, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sugihara
authors.affiliation: Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ishida