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Risk of metachronous colorectal cancer following colectomy in Lynch syndrome: a systematic review and meta‐analysis

Aim Lynch syndrome (LS) accounts for 2–4% of all colorectal cancer (CRC) cases, and is associated with an increased risk of developing metachronous colorectal cancer (mCRC). The role of extended colectomy in LS CRC is controversial. There are limited studies comparing the risk of mCRC following segm...

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Bibliographic Details
Published in:Colorectal disease 2017-06, Vol.19 (6), p.528-536
Main Authors: Anele, C. C., Adegbola, S. O., Askari, A., Rajendran, A., Clark, S. K., Latchford, A., Faiz, O. D.
Format: Article
Language:English
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Summary:Aim Lynch syndrome (LS) accounts for 2–4% of all colorectal cancer (CRC) cases, and is associated with an increased risk of developing metachronous colorectal cancer (mCRC). The role of extended colectomy in LS CRC is controversial. There are limited studies comparing the risk of mCRC following segmental colectomy and extended colectomy. The objective of this systematic review is to evaluate the risk of developing mCRC following segmental and extended colectomy for LS CRC and endoscopic compliance. Method A systematic review of major databases was performed using predefined terms. All original articles published in English comparing the risk of mCRC in LS patients after segmental and extended colectomy from 1950 to January 2016 were included. Results The search retrieved 324 studies. Six studies involving 871 patients met the inclusion criteria. Of these, 705 (80.9%) underwent segmental colectomy and 166 (19.1%) extended colectomy. Average follow‐up was 91.2 months. The mCRC rate was 22.8% and 6% in the segmental and extended colectomy groups, respectively. The segmental group were over four times more likely to develop mCRC (OR 4.02, 95% CI: 2.01–8.04, P 
ISSN:1462-8910
1463-1318
DOI:10.1111/codi.13679