Gut 54:1501-1502 doi:10.1136/gut.2005.075820
  • Letter

An alternative to prophylactic colectomy for colon cancer prevention in HNPCC syndrome

  1. H F A Vasen1,
  2. W H de Vos tot Nederveen Cappel2
  1. 1The Netherlands Foundation for the Detection of Hereditary Tumours, Leiden, the Netherlands
  2. 2Department of Gastroenterology, Leiden University Medical Centre, Leiden, the Netherlands
  1. 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 …