Sulindac induced regression of colorectal adenomas in familial adenomatous polyposis: evaluation of predictive factors
Autor: | Stanley R. Hamilton, J. A. Offerhaus, Anne J. Krush, Francis M. Giardiello, Linda M. Hylind, Jill D. Brensinger, Susan V. Booker, A. C. Tersmette |
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Přispěvatelé: | Other departments |
Rok vydání: | 1996 |
Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis Adolescent Adenomatous polyposis coli Colorectal cancer medicine.medical_treatment Gastroenterology Familial adenomatous polyposis Adenomatous Polyps Sulindac Internal medicine medicine Humans Single-Blind Method neoplasms Colectomy Univariate analysis Chemotherapy biology business.industry Anti-Inflammatory Agents Non-Steroidal Remission Induction Middle Aged medicine.disease digestive system diseases Adenomatous Polyposis Coli biology.protein Female Colorectal Neoplasms business Research Article medicine.drug |
Zdroj: | Gut, 38(4), 578-581. BMJ Publishing Group |
ISSN: | 0017-5749 |
Popis: | BACKGROUND--Sulindac, a non-steroidal anti-inflammatory drug, causes regression of colorectal adenomas in patients with familial adenomatous polyposis (FAP) but the response is variable. Specific clinical factors predictive of sulindac induced regression have not been studied. METHODS--22 patients with FAP were given sulindac 150 mg orally twice a day. Polyp number and size were determined before treatment and at three months. The relation of nine clinical factors to polyp regression (per cent of baseline polyp number after treatment) was evaluated by univariate and multivariate analysis. RESULTS--After three months of sulindac, polyp number had decreased to 45 per cent of baseline and polyp size to 50 per cent of baseline (p < 0.001 and p < 0.01, respectively). Univariate analysis showed greater polyp regression in older patients (p = 0.004), those with previous colectomy and ileorectal anastomosis (p = 0.001), and patients without identifiable mutation of the APC gene responsible for FAP (p = 0.05). With multivariate regression analysis, response to sulindac treatment was associated with previous subtotal colectomy. CONCLUSIONS--Sulindac treatment seems effective in producing regression of colorectal adenomas of FAP patients with previous subtotal colectomy regardless of baseline polyp number and size. Changed sulindac metabolism, reduced area of the target mucosa, or changed epithelial characteristics after ileorectal anastomosis may explain these findings. |
Databáze: | OpenAIRE |
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