An alternative to prophylactic colectomy for colon cancer prevention in HNPCC syndrome
- 1The Netherlands Foundation for the Detection of Hereditary Tumours, Leiden, the Netherlands
- 2Department of Gastroenterology, Leiden University Medical Centre, Leiden, the Netherlands
- Correspondence to:
Dr H F A Vasen
The Netherlands Foundation for the Detection of Hereditary Tumours, Rijnsburgerweg 10, 2333 AA, Leiden, the Netherlands;
The surgical option for treatment of a patient with screen detected colorectal cancer (CRC) from a family with hereditary non-polyposis colorectal cancer (HNPCC) is subtotal colectomy or segmental resection. Using decision analysis, we showed that subtotal colectomy performed at a young age leads to an increased life expectancy (LE) of 1–2.3 years. Based on these results and the high risk of developing a second CRC, we concluded that if CRC is detected in a young patient participating in a surveillance programme, colectomy with ileorectal anastomosis seems to be the treatment of choice.
A French Committee on HNPCC commented on our study.1 Firstly, they stated that using quality adjusted LE would be a more accurate approach. We agree completely but studies on quality of life (QOL) did not specifically consider HNPCC patients. In …