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Friday, November 09, 2012

repost: Upper urinary tract carcinoma in Lynch syndrome cases. [J Urol. 2011] - PubMed - NCBI (note: cancer of the ureter)

Upper urinary tract carcinoma in Lynch syndrome cases. [J Urol. 2011] - PubMed - NCBI


Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA. david.crockett@unmc.edu



Patients with Lynch syndrome are much more likely to have generally rare upper urinary tract urothelial carcinoma but not bladder urothelial carcinoma. While the risk has been quantified, to our knowledge there is no description of how this population of patients with Lynch syndrome and upper urinary tract cancer differs from the general population with upper urinary tract cancer.


Of the patients with Lynch syndrome 91% had mutations in MSH2 rather than in MSH1 and 79% showed upper tract urothelial carcinoma a mean of 15.85 years after prior Lynch syndrome-type cancer. Median age at diagnosis was 62 years vs 70 in the general population (p <0.0001). Only half of our patients had a significant smoking history and the male-to-female ratio was 0.95. Of patients with Lynch syndrome 51% had urothelial carcinoma in the ureter while it occurred in the renal pelvis in 65% of the general population (p = 0.0013). Similar numbers of high grade tumors were found in the Lynch syndrome and general populations (88% and 74%, respectively, p = 0.1108).


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