ASCO/SSO review of current role of risk-reducing surgery in common hereditary cancer syndromes

José G. Guillem, William C. Wood, Jeffrey F. Moley, Andrew Berchuck, Beth Y. Karlan, David G. Mutch, Robert F. Gagel, Jeffrey Weitzel, Monica Morrow, Barbara L. Weber, Francis M Giardiello, Miguel A. Rodriguez-Bigas, James Church, Stephen Gruber, Kenneth Offit

Research output: Contribution to journalArticle

Abstract

Although the etiology of solid cancers is multifactorial, with environmental and genetic factors playing a variable role, a significant portion of the burden of cancer is accounted for by a heritable component. Increasingly, the heritable component of cancer predispositions has been linked to mutations in specific genes, and clinical interventions have been formulated for mutation carriers within affected families. The primary interventions for mutations carriers for highly penetrant syndromes such as multiple endocrine neoplasias, familial adenomatous polyposis, hereditary nonpolyposis colon cancer, and hereditary breast and ovarian cancer syndromes are primarily surgical. For that reason, the American Society of Clinical Oncology (ASCO) and the Society of Surgical Oncology (SSO) have undertaken an educational effort within the oncology community. A joint ASCO/SSO Task Force was charged with presenting an educational symposium on the surgical management of hereditary cancer syndromes at the annual ASCO and SSO meetings, resulting in an educational position article on this topic. Both the content of the symposium and the article were developed as a consensus statement by the Task Force, with the intent of summarizing the current standard of care. This article is divided into four sections addressing breast, colorectal, ovarian and endometrial cancers, and multiple endocrine neoplasia. For each, a brief introduction on the genetics and natural history of the disease is provided, followed by a detailed description of modern surgical approaches, including a description of the clinical and genetic indications and timing of prophylactic surgery, and the efficacy of prophylactic surgery when known. Although a number of recent reviews have addressed the role of genetic testing for cancer susceptibility, including the richly illustrated Cancer Genetics and Cancer Predisposition Testing curriculum by the ASCO Cancer Genetics Working Group (available through http://www.asco.org), this article focuses on the issues surrounding the why, how, and when of surgical prophylaxis for inherited forms of cancer. This is a complex process, which requires a clear understanding of the natural history of the disease and variance of penetrance, a realistic appreciation of the potential benefit and risk of a risk-reducing procedure in a potentially otherwise healthy individual, the long-term sequelae of such surgical intervention, as well as the individual patient and family's perception of surgical risk and anticipated benefit.

Original languageEnglish (US)
Pages (from-to)4642-4660
Number of pages19
JournalJournal of Clinical Oncology
Volume24
Issue number28
DOIs
StatePublished - Oct 1 2006
Externally publishedYes

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Hereditary Neoplastic Syndromes
Medical Oncology
Neoplasms
Multiple Endocrine Neoplasia
Genetic Testing
Advisory Committees
Mutation
Hereditary Breast and Ovarian Cancer Syndrome
Breast Neoplasms
Hereditary Nonpolyposis Colorectal Neoplasms
Adenomatous Polyposis Coli
Surgical Oncology
Penetrance
Standard of Care
Endometrial Neoplasms
Curriculum
Ovarian Neoplasms
Colorectal Neoplasms
Consensus
Joints

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Guillem, J. G., Wood, W. C., Moley, J. F., Berchuck, A., Karlan, B. Y., Mutch, D. G., ... Offit, K. (2006). ASCO/SSO review of current role of risk-reducing surgery in common hereditary cancer syndromes. Journal of Clinical Oncology, 24(28), 4642-4660. https://doi.org/10.1200/JCO.2005.04.5260

ASCO/SSO review of current role of risk-reducing surgery in common hereditary cancer syndromes. / Guillem, José G.; Wood, William C.; Moley, Jeffrey F.; Berchuck, Andrew; Karlan, Beth Y.; Mutch, David G.; Gagel, Robert F.; Weitzel, Jeffrey; Morrow, Monica; Weber, Barbara L.; Giardiello, Francis M; Rodriguez-Bigas, Miguel A.; Church, James; Gruber, Stephen; Offit, Kenneth.

In: Journal of Clinical Oncology, Vol. 24, No. 28, 01.10.2006, p. 4642-4660.

Research output: Contribution to journalArticle

Guillem, JG, Wood, WC, Moley, JF, Berchuck, A, Karlan, BY, Mutch, DG, Gagel, RF, Weitzel, J, Morrow, M, Weber, BL, Giardiello, FM, Rodriguez-Bigas, MA, Church, J, Gruber, S & Offit, K 2006, 'ASCO/SSO review of current role of risk-reducing surgery in common hereditary cancer syndromes', Journal of Clinical Oncology, vol. 24, no. 28, pp. 4642-4660. https://doi.org/10.1200/JCO.2005.04.5260
Guillem, José G. ; Wood, William C. ; Moley, Jeffrey F. ; Berchuck, Andrew ; Karlan, Beth Y. ; Mutch, David G. ; Gagel, Robert F. ; Weitzel, Jeffrey ; Morrow, Monica ; Weber, Barbara L. ; Giardiello, Francis M ; Rodriguez-Bigas, Miguel A. ; Church, James ; Gruber, Stephen ; Offit, Kenneth. / ASCO/SSO review of current role of risk-reducing surgery in common hereditary cancer syndromes. In: Journal of Clinical Oncology. 2006 ; Vol. 24, No. 28. pp. 4642-4660.
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