welcome to oneFAPvoice
- a positively charged Familial Adenomatous Polyposis community.- join today!
- login
Risk Factors Predicting Desmoid Occurrence in Patients With Familial Adenomatous Polyposis: A Meta-analysis
source: Colorectal disease
year: 2011
authors: Sinha A, Tekkis P P, Gibbons D C, Phillips R K, Clark S K
summary/abstract:AIM:
Desmoid tumours (DT) are myofibroblastic proliferations occurring in 15% of patients with familial adenomatous polyposis (FAP). Several small series have analysed the incidence of DT and predisposing risk factors. Using meta-analytical techniques, this study aimed to identify risk factors for DT development in patients with FAP.
METHOD:
Studies of sporadic DT were excluded. The study end-points were the incidence of DT in FAP and DT development by gender, adenomatous polyposis coli (APC) mutation, family history of DT and previous abdominal surgery. A random effect Mantel-Haenszel model was used to calculate odds ratios for each risk factor and age group.
RESULTS:
Ten studies of 4625 patients with FAP fulfilled our inclusion criteria. A total of 559 (12%) patients developed DT. Cumulative analysis demonstrated that 80% of DT developed by age 40, the peak incidence rate being in the second and third decades. A positive family history of DT was the most significant risk factor (OR 7.02, 95% CI 4.15-11.9, P < 0.001). An APC mutation 3′ to codon 1399 (OR 4.37, 95% CI 2.14-8.91, P < 0.001) and previous abdominal surgery (OR 3.35, 95% CI 1.33-8.41, P = 0.01) were also implicated. Women were more likely to develop DT (OR 1.57, 95% CI 1.13-2.18, P = 0.007).
CONCLUSION:
There is consistency amongst polyposis registries in documenting the incidence and risk factors for DT development. Having a positive family history for DT is of greater significance than a 3′ mutation, suggesting the existence of modifier genes, independent of the APC genotype-phenotype correlation. Few of these risk factors are modifiable. Delaying prophylactic surgery could be appropriate in female patients with a 3′ APC mutation and attenuated polyposis.
DOI: 10.1111/j.1463-1318.2010.02345.x
read more full text source
expertly curated content related to this topic
-
Acute Pancreatitis as the Initial Manifestation of an Adenocarcinoma of the Major Duodenal Papilla in a Patient With...We report a case of an ampullary carcino...
-
New Brunswick Colon Cancer Screening Clinical Practice GuidelinesThe New Brunswick Cancer Network (NBCN) ...
-
Nexavar Narrative: 7 Month Updatehttps://www.youtube.com/watch?v=4I3D66vr...
-
Tumor Progression in Colon Cancerhttp://www.discoveryandinnovation.com/BI...
-
Familial Adenomatous Polyposis and Other Polyposis SyndromesThis book discusses Familial Adenomatou...
-
Familial Adenomatous PolyposisFamilial adenomatous polyposis affects m...
-
Familial Adenomatous PolyposisFamilial adenomatous polyposis (FAP) is ...