Decision Making Regarding Therapeutic Options for Multiple Colorectal Cancer in HNPCC

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  • 遺伝性非ポリポーシス大腸癌の大腸多発癌に対する治療法の選択

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An excess of multiple colorectal cancers has been reported in hereditary non-polyposis colorectal cancer （HNPCC）. The management of patients with colorectal cancer（CRC）should include segmental colectomy in cases of sporadic CRC, and prophylactic subtotal colectomy. The patients need to know that an alternative to subtotal colectomy is segmental colectomy followed by lifelong colonoscopic surveillance. The decision to choose the therapeutic option is made in consideration of the following conditions: method of diagnosis, affection of cancer, site of CRC, age at the onset of CRC, tolerance to operation, and anal sphincter function. In cases of families with a history suggestive of HNPCC but in which the Amsterdam criteria have not been fulfilled, decision making is often difficult. Extended hemicolectomy is a procedure in which half the length of the colon is resected. We propose that extended hemicolectomy should be included as one of the therapeutic options for HNPCC.

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