A study evaluates the effectiveness of colon and gynecological surgeries and their risk reduction in patients affected by Lynch syndrome

A study carried out by the Hereditary Cancer Group of the Bellvitge Biomedical Research Institute (IDIBELL) – Catalan Institute of Oncology (ICO), with the collaboration of the General and Digestive Surgery, Gynecology and Pathology Services of the Bellvitge University Hospital and Germans Trias i Pujol University Hospital, has analyzed the impact of risk-reducing surgeries in the incidence and mortality of Lynch Syndrome’s colon and gynecological cancer.

Colorectal cancer and endometrial cancer represent a significant risk to life in individuals with Lynch syndrome, with an incidence at 75 years of up to 40-60%. Furthermore, monitoring of these tumors, especially gynecological tumors, has not been shown to be effective. Thus, risk-reducing surgeries may represent an interesting option for people affected by this syndrome, leading to a reduction in the incidence of cancer and its mortality.

How has this study been carried out?

This study analyzed the cumulative incidence of cancer and mortality from colorectal, endometrial and ovarian cancer in 976 patients with Lynch Syndrome. These patients could be in cancer follow-up programs or have undergone risk-reducing surgery, both colon after the first diagnosis of colorectal cancer, and gynecological in women without a previous diagnosis of endometrial or ovarian cancer.

After a mean follow-up of 10.2 years, a statistically significant decrease in the cumulative incidence of metachronous colorectal cancer has been demonstrated after performing extensive colon surgery as a treatment for the first colorectal cancer (12.5% of extensive surgery versus 44.7% of segmental surgery, p=0.04). In addition, a statistically significant decrease in the cumulative incidence of endometrial cancer has also been shown (11.2% of risk-reducing gynecological surgery versus 46.3% of follow-up, p=0.001); ovarian cancer (0.0% risk-reducing gynecological surgery vs. 12.7% follow-up, p=N/A) and all-cause mortality (0.0% risk-reducing gynecological surgery vs. 52.7% of follow-up, p=0.001) after performing risk-reducing gynecological surgery.

According to the researcher and first author of the article, Núria Dueñas, “these data are important because it is the first study published where a reduction in mortality is shown, for any cause and specific cancer, in women affected by Lynch syndrome with risk-reducing gynecological surgery “.