title: Clinical outcomes of gastric polyps and neoplasms in patients with familial adenomatous polyposis.
abstract: Background and study aimsFamilial adenomatous polyposis (FAP) is an autosomal dominant syndrome caused by a germline mutation in the adenomatous polyposis coli (APC) gene, characterized by the presence of more than 100 adenomatous polyps in the colorectum. The upper gastrointestinal tract is an extracolonic site for malignancy in patients with FAP. The frequency of death in Japanese patients with FAP because of gastric cancer is 2.8 % and that because of colon cancer is 60.6 %. Few studies have reported upper gastrointestinal diseases in patients with FAP. In the present study, we investigated the clinical outcomes of patients with FAP diagnosed with gastric neoplasms.Patients and methodsWe enrolled 80 patients with FAP who underwent esophagogastroduodenoscopy from October 1997 to December 2011. We investigated patient characteristics, endoscopic findings of gastric lesions, treatment outcomes, and long-term courses.ResultsFundic gland polyposis was observed in 51 patients (64 %) and gastric neoplasms in 22 patients (28 %), including 20 with non-invasive and 2 with invasive neoplasm. Of the 26 neoplasms, 11 were treated by endoscopic resection (ER) and 4 by surgical resection. Metachronous gastric neoplasms were observed in 7 patients (15 lesions) and treated by ER, except for in 1 patient. No patients died of gastric lesions during a median follow-up period of 6.5 years (range, 0 - 14).ConclusionBecause gastric lesions including gastric cancers in patients with FAP did not cause any deaths, they can be considered to have favorable prognoses. Early detection of gastric neoplasms through an appropriate follow-up interval may have contributed to these good outcomes.
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan; Department of Surgical Pathology, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Keiko
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authors.lastname: Nakamura
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Satoru
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authors.lastname: Nonaka
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Takeshi
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authors.lastname: Nakajima
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Tatsuo
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authors.lastname: Yachida
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Seiichiro
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authors.lastname: Abe
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Taku
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authors.lastname: Sakamoto
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Haruhisa
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authors.lastname: Suzuki
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Shigetaka
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authors.lastname: Yoshinaga
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Ichiro
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authors.lastname: Oda
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Takahisa
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authors.lastname: Matsuda
authors.affiliation: Pathology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Shigeki
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authors.lastname: Sekine
authors.affiliation: Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yukihide
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authors.lastname: Kanemitsu
authors.affiliation: Gastric Surgery Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Hitoshi
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authors.lastname: Katai
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Department of Surgical Pathology, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Hirota