Clinical outcomes of gastric polyps and neoplasms in patients with familial adenomatous polyposis

Keiko Nakamura; Satoru Nonaka; Takeshi Nakajima; Tatsuo Yachida; Seiichiro Abe; Taku Sakamoto; Haruhisa Suzuki; Shigetaka Yoshinaga; Ichiro Oda; Takahisa Matsuda; Shigeki Sekine; Yukihide Kanemitsu; Hitoshi Katai; Yutaka Saito; Seiichi Hirota

doi:10.1055/s-0042-119809

Endoscopy International Open, Table of Contents

CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(03): E137-E145
DOI: 10.1055/s-0042-119809

Original article

Clinical outcomes of gastric polyps and neoplasms in patients with familial adenomatous polyposis

Keiko Nakamura

¹Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

⁵Department of Surgical Pathology, Hyogo College of Medicine, Hyogo, Japan

,

Satoru Nonaka

¹Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

,

Takeshi Nakajima

¹Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

,

Tatsuo Yachida

¹Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

,

Seiichiro Abe

¹Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

,

Taku Sakamoto

¹Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

,

Haruhisa Suzuki

¹Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

,

Shigetaka Yoshinaga

¹Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

,

Ichiro Oda

¹Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

,

Takahisa Matsuda

¹Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

,

Shigeki Sekine

²Pathology Division, National Cancer Center Hospital, Tokyo, Japan

,

Yukihide Kanemitsu

³Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan

,

Hitoshi Katai

⁴Gastric Surgery Division, National Cancer Center Hospital, Tokyo, Japan

,

Yutaka Saito

¹Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

,

Seiichi Hirota

⁵Department of Surgical Pathology, Hyogo College of Medicine, Hyogo, Japan

› Author Affiliations

Abstract

Background and study aims Familial 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 methods We 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.

Results Fundic 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).

Conclusion Because 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.

Full Text

References

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