Germline mutation of the CDH1 gene, which encodes for the E-cadherin adhesion protein, is rare but confers an estimated lifetime risk of hereditary diffuse gastric cancer higher than 80 %. Prophylactic total gastrectomy seems to eliminate the high risk of developing diffuse gastric cancer in patients with this mutation. Current guidelines propose an accurate pre-operative work-up to engage patients at risk who can be good candidates for prophylactic surgery. In this chapter we analyze the general indications to prophylactic total gastrectomy and the diagnostic and therapeutic work-up, with particular reference to the techniques most used and recommended. We also investigate the metabolic consequences of a total gastrectomy and its impact on the patient's quality of life, together with the possible complications can be caused by this kind of operation.
Ferrara F., Corso G., Roviello F. (2013). Prophylactic total gastrectomy in CDH1 germline mutation carriers. In Spotlight on Familial and Hereditary Gastric Cancer (pp. 167-176). Springer Netherlands [10.1007/978-94-007-6570-2_14].
Prophylactic total gastrectomy in CDH1 germline mutation carriers
Ferrara F.;
2013-01-01
Abstract
Germline mutation of the CDH1 gene, which encodes for the E-cadherin adhesion protein, is rare but confers an estimated lifetime risk of hereditary diffuse gastric cancer higher than 80 %. Prophylactic total gastrectomy seems to eliminate the high risk of developing diffuse gastric cancer in patients with this mutation. Current guidelines propose an accurate pre-operative work-up to engage patients at risk who can be good candidates for prophylactic surgery. In this chapter we analyze the general indications to prophylactic total gastrectomy and the diagnostic and therapeutic work-up, with particular reference to the techniques most used and recommended. We also investigate the metabolic consequences of a total gastrectomy and its impact on the patient's quality of life, together with the possible complications can be caused by this kind of operation.File | Dimensione | Formato | |
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