New Delhi: In patients of Lynch syndrome — an inherited condition — risk of developing a second tumour could be lower among those having an extended resection, involving a removal of organs and tissues adjacent to the affected ones, compared to segmental resection, according to a study. The inherited condition increases one’s risk of cancer, especially that of colon and rectum.
An international collaboration, including researchers from the Institute of Human Genetics, Ahmedabad, compared the incidence of metachronous colorectal cancer — the second cancer develops distinct from and at least six months following diagnosis of the first — after segmental versus extended surgical resection in patients with Lynch syndrome.
The analysis looked at data taken from the ‘Prospective Lynch Syndrome Database’, involving 8,500 patients from 25 different countries. Findings are published in the British Journal of Surgery.
Once colon cancer is identified, European and American guidelines recommend considering an extended colorectal surgery for patients of Lynch syndrome carrying the ‘path_MLH1’ and ‘path_MSH2’ gene variants, and a segmental resection for those carrying the ‘path_MSH6’ and ‘path_PMS2’ gene variants.
All these gene variants are associated with a higher lifetime risk of developing colorectal, gynaecological and urinary tract cancers, among others.
Overall, a higher risk of metachronous colorectal cancer was found to be higher among patients who underwent segmental resection, compared to those who underwent extended surgery.
For example, path_MLH1 carriers had a higher risk of metachronous (colorectal cancer) by the age of 75 years after segmental colorectal resection (69.1 per cent), compared with extended surgery (25.1 per cent), the team said.
“This study has found that path_MLH1 and path_MSH2 carriers who undergo segmental resection for a first colorectal cancer were at increased risk of metachronous colorectal cancer, compared with those with no prior colorectal cancer,” the authors wrote.
They said the study’s findings contributes to the ongoing discussion on surgical strategies for patients with Lynch syndrome.
The research team also included members from the US, Europe and Australia.
