Noh, Jin Hee; Song, Eun Mi; Ahn, Ji Yong; Yang, Dong-Hoon; Lee, Woochang; Hong, Jinyoung; Kim, Aram; Na, Hee Kyong; Lee, Jeong Hoon; Jung, Kee Wook; Kim, Do Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Jung, Hwoon-Yong
Surgical endoscopy
2021Mar ; 25 ( 1 ) :.
PMID : 33709227
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Noh, Jin Hee - Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Song, Eun Mi - Department of Gastroenterology, Ewha Womans University Medical Center, Seoul, Korea.
Ahn, Ji Yong - Department of Gastroenterology, Asan Medical Center, University of Ulsan College of
Yang, Dong-Hoon - Department of Gastroenterology, Asan Medical Center, University of Ulsan College of
Lee, Woochang - Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College
Hong, Jinyoung - Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College
Kim, Aram - Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College
Na, Hee Kyong - Department of Gastroenterology, Asan Medical Center, University of Ulsan College of
Lee, Jeong Hoon - Department of Gastroenterology, Asan Medical Center, University of Ulsan College of
Jung, Kee Wook - Department of Gastroenterology, Asan Medical Center, University of Ulsan College of
Kim, Do Hoon - Department of Gastroenterology, Asan Medical Center, University of Ulsan College of
Choi, Kee Don - Department of Gastroenterology, Asan Medical Center, University of Ulsan College of
Song, Ho June - Department of Gastroenterology, Asan Medical Center, University of Ulsan College of
Lee, Gin Hyug - Department of Gastroenterology, Asan Medical Center, University of Ulsan College of
Jung, Hwoon-Yong - Department of Gastroenterology, Asan Medical Center, University of Ulsan College of
ABSTRACT
BACKGROUND: Although upper gastrointestinal (GI) neoplasms are not rare in patients with familial adenomatous polyposis (FAP), few studies have focused on them and the long-term outcomes of their treatment by endoscopy. Therefore, we aimed to investigate the prevalence and endoscopic treatment outcomes of upper GI neoplasms in patients with FAP.
METHODS: Among 215 patients diagnosed with FAP between January 1991 and December 2019, 208 who underwent esophagogastroduodenoscopy were eligible. The clinical features and endoscopic treatment outcomes of upper GI neoplasms were retrospectively investigated and analyzed.
RESULTS: Among the enrolled patients, 113 (54.3%) had one or more upper GI neoplasms: gastric adenoma (n?=?34), gastric cancer (n?=?7), nonampullary duodenal adenoma (n?=?86), and ampullary adenoma (n?=?53). Among patients with gastric neoplasms (n?=?37), 24 (64.9%) underwent treatment (endoscopic treatment: 22, surgery: 2). No tumor-related mortality occurred during median follow-up of 106?months (interquartile range [IQR] 63-174). Endoscopic treatment was performed in 47 (54.7%) of 86 patients with nonampullary duodenal adenoma and in 32 (60.4%) of 53 patients with ampullary adenoma. No patient underwent surgery for duodenal neoplasms, and no tumor-related mortality occurred during median follow-up of 88?months (IQR 42-145). The proportion of patients with increased Spigelman stage at 2?years after the initial diagnosis or treatment was significantly higher in untreated group than in the group treated for duodenal neoplasms (27.3% vs. 0.0%, p?=?0.001). CONCLUSION: Endoscopic surveillance in FAP patients is important for the detection and treatment of upper GI neoplasms in early stage. In particular, endoscopic therapy for duodenal neoplasms can reduce the severity of duodenal polyposis. CI - ??2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
keyword
Adenomatous polyposis coli; Duodenal adenoma; Endoscopic treatment; Familial adenomatous polyposis; Gastric adenoma; Gastric cancer
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