SURGICAL AND MEDICAL MANAGEMENT OF HEREDITARY NON-POLYPOSIS COLO-RECTAL CANCER MANAGEMENT OF HNPCC

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Article Title:	SURGICAL AND MEDICAL MANAGEMENT OF HEREDITARY NON-POLYPOSIS COLO-RECTAL CANCER MANAGEMENT OF HNPCC
Authors:	Carolina Negrei1, Corina Dalia Toderescu2*, Bianca Galateanu3, Cristian Balalau4, Miriana Stan1, Claudia Gutu1, Octav Ginghina5
Affiliation:	1Department of Toxicology, “Carol Davila” University of Medicine and Pharmacy, 6, Traian Vuia Street, Bucharest, Romania 2 Department of Pharmaceutical Sciences, Faculty of Pharmacy, ”Vasile Goldis” Western University of Arad, 91-93, L. Rebreanu Street, Arad, Romania 3Department of Biochemistry and Molecular Biology, University of Bucharest, Bucharest, Romania 4“Sf. Pantelimon” Hospital Bucharest, Surgical Clinic, “Carol Davila” University of Medicine and Pharmacy, 340-342, Pantelimon Street, Bucharest, Romania 5“St. John Emergency Hospital” Bucharest, Surgical Clinic, “Carol Davila” University of Medicine and Pharmacy, 13, Vitan-Barzesti Street, Bucharest, Romania
Abstract:	Hereditary non-polyposis colo-rectal cancer is an autosomal dominant disease and is described by markedly higher risk for colon and endometrial cancers. This disorder is characterised by loss of mismatch repair protein expression and DNA microsatellite instability. Clinical criteria (Amsterdam II) have served in identifying hereditary non-polyposis colo-rectal cancer families. To facilitate determination of colo-rectal tumours requiring molecular analysis, certain clinical criteria have been developed (Bethesda Guidelines). The recommendations for screening are for yearly/biennial colonoscopy and annual trans-vaginal ultrasound and endometrial sampling as early as 20 to 35 years of age. The management of this disorder, given the increased risk of developing endometrial and ovarian cancer, bilateral salpingoophorectomy and prophylactic hysterectomy should be presented to and discussed with HNPCC patients and also options for such patients’ management include completion colectomy and ileo-rectal anastomosis, monitoring or chemo-prevention, in case of colo-rectal cancer.
Keywords:	colo-rectal cancer, endometrial cancer, colectomy, hysterectomy
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*Correspondence:	Corina Dalia Toderescu, ”Vasile Goldis” Western University of Arad, Faculty of Pharmacy, Department of Pharmaceutical Sciences, no. 91-93, L. Rebreanu Street, Arad, Romania, email: corytd11@yahoo.com