Upper gastrointestinal neoplasia in familial adenomatous polyposis: prevalence, endoscopic features and management

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorCAMPOS, Fabio Guilherme
dc.contributor.authorMARTINEZ, Augusto Real
dc.contributor.authorSULBARAN, Marianny
dc.contributor.authorBUSTAMANTE-LOPEZ, Leonardo Alfonso
dc.contributor.authorSAFADE-RIBEIRO, Adriana Vaz
dc.date.accessioned2019-08-20T14:53:06Z
dc.date.available2019-08-20T14:53:06Z
dc.date.issued2019
dc.description.abstractBackground: To evaluate the prevalence of upper gastrointestinal (GI) polyps in familial adenomatous polyposis (FAP), and to discuss current therapeutic recommendations. Methods: Clinical, endoscopic, histological and treatment data were retrieved from charts of 102 patients [1958-2016]. Duodenal adenomatosis was classified according to Spigelman stages. Results: this series comprised 59 women (57.8%) and 43 men (42.1%) with a median age of 32.3 years. Patients underwent 184 endoscopic procedures, the first at a median age of 35.9 years (range, 13-75 years). Fundic gastric polyps (n=31; 30.4%) prevailed in the stomach. While only 5 adenomas were found in the stomach, 33 patients (32.4%) presented duodenal ones. Advanced lesions (n=13; 12.7%) were detected in the stomach (n=2) and duodenum (n=11). During follow-up, Spigelman stages improved in 6 (12.2%) patients, remained unchanged in 25 (51.0%) and worsened in 18 (36.7%). Carcinomas were diagnosed in the stomach and duodenum (4 lesions each, 3.9%), at median ages of 50.2 and 55.0 years, respectively. Advanced lesions and carcinomas were managed through local or surgical resections. Severe complications occurred in only 2 patients (one death). Enteroscopy in 21 patients revealed jejunal adenomas in 12, 11 of whom also presented duodenal adenomas. Conclusions: There is a high prevalence of upper GI adenomas and cancer in FAP. There were diagnosed fundic gastric polyps (30.4%), duodenal (32.4%) and jejunal adenomas (11.8%), respectively. One third of duodenal polyps progressed slowly throughout the study. The rates of advanced gastroduodenal lesions (12.7%) and cancer (7.8%) raise the need for continuous surveillance during follow-up.eng
dc.description.indexPubMedeng
dc.identifier.citationJOURNAL OF GASTROINTESTINAL ONCOLOGY, v.10, n.4, p.734-744, 2019
dc.identifier.doi10.21037/jgo.2019.03.06
dc.identifier.eissn2219-679X
dc.identifier.issn2078-6891
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/33252
dc.language.isoeng
dc.publisherPIONEER BIOSCIENCE PUBL COeng
dc.relation.ispartofJournal of Gastrointestinal Oncology
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright PIONEER BIOSCIENCE PUBL COeng
dc.subjectFamilial adenomatous polyposis (FAP)eng
dc.subjectadenomaseng
dc.subjectduodenumeng
dc.subjectsmall boweleng
dc.subjectsurveillanceeng
dc.subject.otherfundic gland polypseng
dc.subject.otherduodenal adenomatosiseng
dc.subject.otherampullary adenomaseng
dc.subject.othernatural-historyeng
dc.subject.otherclinical characteristicseng
dc.subject.othergastroduodenal polypseng
dc.subject.othersurgical-managementeng
dc.subject.othersurveillanceeng
dc.subject.othercancereng
dc.subject.otherriskeng
dc.subject.wosOncologyeng
dc.subject.wosGastroenterology & Hepatologyeng
dc.titleUpper gastrointestinal neoplasia in familial adenomatous polyposis: prevalence, endoscopic features and managementeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus14
hcfmusp.contributor.author-fmusphcFABIO GUILHERME CASERTA MARYSSAEL DE CAMPOS
hcfmusp.contributor.author-fmusphcCARLOS AUGUSTO REAL MARTINEZ
hcfmusp.contributor.author-fmusphcMARIANNY NAZARETH SULBARAN NAVA
hcfmusp.contributor.author-fmusphcLEONARDO ALFONSO BUSTAMANTE LOPEZ
hcfmusp.contributor.author-fmusphcADRIANA VAZ SAFATLE RIBEIRO
hcfmusp.description.beginpage734
hcfmusp.description.endpage744
hcfmusp.description.issue4
hcfmusp.description.volume10
hcfmusp.origemWOS
hcfmusp.origem.scopus2-s2.0-85072595733
hcfmusp.origem.wosWOS:000474645400016
hcfmusp.publisher.cityHONG KONGeng
hcfmusp.publisher.countryPEOPLES R CHINAeng
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