oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2018-17-4-48-52oncotomsk-815Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESНАСЛЕДСТВЕННЫЙ РАК ЖЕЛУДКА ДИФФУЗНОГО ТИПА: ГЕНЕТИЧЕСКИЕ АСПЕКТЫ И ПРОФИЛАКТИЧЕСКАЯ ТОТАЛЬНАЯ ГАСТРЭКТОМИЯHEREDITARY DIFFUSE GASTRIC CANCER: GENETIC ASPECTS AND PROPHYLACTIC TOTAL GASTRECTOMYЛюбченкоЛ. Н.LyubchenkoL. N.

Россия, 115478, г. Москва, Каширское шоссе, 24

доктор медицинских наук, руководитель лаборатории клинической онкогенетики, ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» МЗ РФ 

SPIN-код: 9589-9057. Author ID (Scopus): 6603827727

24, Kashirskoye shosse, 115478-Moscow, Russia

MD, DSc, Head of Laboratory of Clinical Oncogenetics, FSBI «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Health of the Russian Federation

Author ID (Scopus): 6603827727

clingen@mail.ruФилипповаМ. Г.FilippovaM. G.

Россия, 115478, г. Москва, Каширское шоссе, 24

кандидат медицинских наук, старший научный сотрудник лаборатории клинической онкогенетики, ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» МЗ РФ

SPIN-код: 1927-6110

24, Kashirskoye shosse, 115478-Moscow, Russia

MD, PhD, Senior Researcher, Laboratory of Clinical Oncogenetics, FSBI «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Health of the Russian Federation

fimargarita@yandex.ruАнуроваО. А.AnurovaO. A.

Россия, 115478, г. Москва, Каширское шоссе, 24

кандидат медицинских наук, ведущий научный сотрудник отдела патологоанатомической анатомии опухолей человека, ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» МЗ РФ

Author ID (РИНЦ): 167847

24, Kashirskoye shosse, 115478-Moscow, Russia

PhD, Leading Researcher, Human Pathological Anatomy and Tumor Department, FSBI «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Health of the Russian Federation

НазлиевП. В.NazlievP. B.

Россия, 115478, г. Москва, Каширское шоссе, 24

кандидат медицинских наук, старший научный сотрудник отделения научно-консультативныхамбулаторных методов диагностики и лечения ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» МЗ РФ

SPIN-код: 2955-1089

24, Kashirskoye shosse, 115478-Moscow, Russia

PhD, Senior Researcher, Department of scientific advisory outpatient diagnostic and treatment methods FSBI «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Health of the Russian Federation

https://orcid.org/0000-0002-5229-8203СтилидиИ. С.StilidiI. S.

Россия, 115478, г. Москва, Каширское шоссе, 24

член-корреспондент РАН, доктор медицинских наук, профессор, директор ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» МЗ РФ 

SPIN-код: 9622-7106. Author ID (Scopus): 6602949492 

24, Kashirskoye shosse, 115478-Moscow, Russia

MD, DSc, Corresponding Member of the Russian Academy of Sciences, professor, Head of FSBI «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Health of the Russian Federation 

Author ID (Scopus): 6602949492

Национальный медицинский исследовательский центр имени Н.Н.Блохина Министерства здравоохранения Российской ФедерацииРоссияN.N. Blokhin Medical Research Center of Oncology, Ministry of Health of the Russian FederationRussian Federation2018020920181744852Copyright © Любченко Л.Н., Филиппова М.Г., Анурова О.А., Назлиев П.В., Стилиди И.С., 20182018Любченко Л.Н., Филиппова М.Г., Анурова О.А., Назлиев П.В., Стилиди И.С.Lyubchenko L.N., Filippova M.G., Anurova O.A., Nazliev P.B., Stilidi I.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/815

Для пациентов с выявленной наследственной мутацией E-cadherin-1 (CDH1) терапией выбора является  профилактическая гастрэктомия для устранения риска развития рака диффузного типа. Представленный  клинический пример описывает редкий случай наследственного рака желудка диффузного типа (HDGC),  ассоциированного с мутацией в гене CDH1, впервые описанного в России. В 2013 году 28-летняя пациентка  была поставлена на учет в клинической онкогенетической лаборатории с семейной историей рака желудка.  Молекулярно-генетический анализ выявил наследственную мутацию в гене CDH1. Риск заболеть раком в  течение жизни у пациентов с выявленной мутацией превышает 80 %. Гистологическое исследование  биопсийного образца, полученного при эндоскопии, обнаружило изолированные мелко-круглые клетки в lamina  propria. В отделе абдоминальной онкологии пациентке было проведено хирургическое вмешательство:  лимфодиссекция в объеме D2 с сохранением селезенки и тотальная гастрэктомия с Roux-en-Y реконструкцией с  формированием тощекишечного резервуара.

For patients with an identified germline E-cadherin-1 (CDH1) mutation, prophylactic gastrectomy is the treatment of choice to eliminate the high risk of developing diffuse gastric  cancer. The case report describes a rare case of hereditary diffuse gastric cancer (HDGC)  associated with CDH1 gene mutation, which is reported in the Russian population for the first  time. In 2013, a 28-year- old woman was referred to Clinical Oncogenetics Laboratory with a  family history of gastric cancer. Molecular genetic analysis revealed CDH1 gene mutation. The  lifetime risk of cancer in mutation positive members is more than 80. Histological examination  of gastric biopsy specimens obtained during endoscopy revealed isolated signet ring cells in the  lamina propria. Spleenpreserving D2-lymphodissection and total gastrectomy with Roux-en-Y  reconstruction with a jejunal reservoir formation were performed at the Abdominal Oncology Surgery Department.

наследственный рак желудка диффузного типа (HDGC)ген CDH1гастрэктомиямолекулярно-генетическая диагностикаhereditary diffuse gastric cancer (HDGC)CDH1 genegastrectomymolecular genetic diagnosticsReferencesLe Vecchia C., Negri E., Franceeschi S., Gentile A. Family history and risk of stomach and colorectal canser. Canser. 1992; 70: 50–58.Le Vecchia C., Negri E., Franceeschi S., Gentile A. Family history and risk of stomach and colorectal canser. Canser. 1992; 70: 50–58.Caldas C., Carneiro F., Lynch H.T., Yokota J., Wiesner G.L., Powell S.M., Lewis F.R., Huntsman D.G., Pharoah P.D., Jankowski J.A., MacLeod P., Vogelsang H., Keller G., Park K.G., Richards F.M., Maher E.R., Gayther S.A., Oliveira C., Grehan N., Wight D., Seruca R., Roviello F., Ponder B.A., Jackson C.E. Family gastric canser: overview and guidelines for management. J Med Genet. 1999; 36: 873–80.Caldas C., Carneiro F., Lynch H.T., Yokota J., Wiesner G.L., Powell S.M., Lewis F.R., Huntsman D.G., Pharoah P.D., Jankowski J.A., MacLeod P., Vogelsang H., Keller G., Park K.G., Richards F.M., Maher E.R., Gayther S.A., Oliveira C., Grehan N., Wight D., Seruca R., Roviello F., Ponder B.A., Jackson C.E. Family gastric canser: overview and guidelines for management. J Med Genet. 1999; 36: 873–80.Fitzgerald R.C., Hardwick R., Huntsman D., Carneiro F., Guilford P., Blair V., Chung D.C., Norton J., Ragunath K., Van Krieken J.H., Dwerryhouse S., Caldas C.; International Gastric Cancer Linkage Consortium. Hereditary diffuse gastric cancer: updated consensus guidelines for clinical management and directions for future research. J Med Genet. 2010 Jul; 47(7): 436–44. doi: 10.1136/jmg.2009.074237.Fitzgerald R.C., Hardwick R., Huntsman D., Carneiro F., Guilford P., Blair V., Chung D.C., Norton J., Ragunath K., Van Krieken J.H., Dwerryhouse S., Caldas C.; International Gastric Cancer Linkage Consortium. Hereditary diffuse gastric cancer: updated consensus guidelines for clinical management and directions for future research. J Med Genet. 2010 Jul; 47(7): 436–44. doi: 10.1136/jmg.2009.074237.Guilford P., Hopkins J., Harraway J., McLeod M., McLeod N., Harawira P., Taite H., Scoular R., Miller A., Reeve A.E. E-cadgerin germline mutations in familiar gastric cancer. Nature. 1998; 392: 402‑405.Guilford P., Hopkins J., Harraway J., McLeod M., McLeod N., Harawira P., Taite H., Scoular R., Miller A., Reeve A.E. E-cadgerin germline mutations in familiar gastric cancer. Nature. 1998; 392: 402‑405.Corso G., Marrelli D., Pascale V., Vindigni C., Roviello F. Frequency of CDH1 germline mutations in gastric carcinoma coming from high- and lo-risk areas: metanalysis and systematic rewiew of the literature. BMC Canser. 2012; 2: 8.Corso G., Marrelli D., Pascale V., Vindigni C., Roviello F. Frequency of CDH1 germline mutations in gastric carcinoma coming from high- and lo-risk areas: metanalysis and systematic rewiew of the literature. BMC Canser. 2012; 2: 8.Suriano G., Yew S., Ferreira P., Senz J., Kaurah P., Ford J.M., Longacre T.A., Norton J.A., Chun N., Young S., Oliveira M.J., Macgillivray B., Rao A., Sears D., Jackson C.E., Boyd J., Yee C., Deters C., Pai G.S., Hammond L.S., McGivern B.J., Medgyesy D.,Suriano G., Yew S., Ferreira P., Senz J., Kaurah P., Ford J.M., Longacre T.A., Norton J.A., Chun N., Young S., Oliveira M.J., Macgillivray B., Rao A., Sears D., Jackson C.E., Boyd J., Yee C., Deters C., Pai G.S., Hammond L.S., McGivern B.J., Medgyesy D.,Sartz D., Arun B., Oelschlager B.K., Upton M.P., Neufeld-Kaiser W., Silva O.E., Donenberg T.R., Kooby D.A., Sharma S., Jonsson B.A., Gronberg H., Gallinger S., Seruca R., Lynch H., Huntsman D.G. Characterization of a recurrent germ line mutation of the Ecadherin gene: implications for genetic testing and clinical management. Clin Cancer Res 2005; 11: 5401–9. doi: 10.1158/1078-0432.CCR-05-0247.Sartz D., Arun B., Oelschlager B.K., Upton M.P., Neufeld-Kaiser W., Silva O.E., Donenberg T.R., Kooby D.A., Sharma S., Jonsson B.A., Gronberg H., Gallinger S., Seruca R., Lynch H., Huntsman D.G. Characterization of a recurrent germ line mutation of the Ecadherin gene: implications for genetic testing and clinical management. Clin Cancer Res 2005; 11: 5401–9. doi: 10.1158/1078-0432.CCR-05-0247.Kaurah P., MacMillan A., Boyd N., Senz J., De Luca A., Chun N., Suriano G., Zaor S., Van Manen L., Gilpin C., Nikkel S., Connolly-Wilson M., Weissman S., Rubinstein W.S., Sebold C., Greenstein R., Stroop J., Yim D., Panzini B., McKinnon W., Greenblatt M., Wirtzfeld D., Fontaine D., Coit D., Yoon S., Chung D., Lauwers G., Pizzuti A., Vaccaro C., Redal M.A., Oliveira C., Tischkowitz M., Olschwang S., Gallinger S., Lynch H., Green J., Ford J., Pharoah P., Fernandez B., Huntsman D. Founder and recurrent CDH1 mutations in families with hereditary diffuse gastric cancer. JAMA 2007; 297: 2360–72. doi: 10.1001/jama.297.21.2360.Kaurah P., MacMillan A., Boyd N., Senz J., De Luca A., Chun N., Suriano G., Zaor S., Van Manen L., Gilpin C., Nikkel S., Connolly-Wilson M., Weissman S., Rubinstein W.S., Sebold C., Greenstein R., Stroop J., Yim D., Panzini B., McKinnon W., Greenblatt M., Wirtzfeld D., Fontaine D., Coit D., Yoon S., Chung D., Lauwers G., Pizzuti A., Vaccaro C., Redal M.A., Oliveira C., Tischkowitz M., Olschwang S., Gallinger S., Lynch H., Green J., Ford J., Pharoah P., Fernandez B., Huntsman D. Founder and recurrent CDH1 mutations in families with hereditary diffuse gastric cancer. JAMA 2007; 297: 2360–72. doi: 10.1001/jama.297.21.2360.Norton J.A., Ham C.M., Jacques Van Dam R., Longacre T.A., Huntsman D.G., Chun N., Ford J.M. CDH1 truncating mutations in the Ecadherin gene: an indication for total gastrectomy to treat hereditary diffuse gastric cancer. Ann Surg 2007; 245: 873–9.Norton J.A., Ham C.M., Jacques Van Dam R., Longacre T.A., Huntsman D.G., Chun N., Ford J.M. CDH1 truncating mutations in the Ecadherin gene: an indication for total gastrectomy to treat hereditary diffuse gastric cancer. Ann Surg 2007; 245: 873–9.Jonsson B.A., Bergh A., Stattin P., Emmanuelsson M., Gronberg H. Germline mutations in E-cadherin do not explain association of hereditary prostate cancer, gastric cancer and breast cancer. Int J Cancer 2002; 98: 838–43.Jonsson B.A., Bergh A., Stattin P., Emmanuelsson M., Gronberg H. Germline mutations in E-cadherin do not explain association of hereditary prostate cancer, gastric cancer and breast cancer. Int J Cancer 2002; 98: 838–43.Suriano G., Oliveira C., Ferreira P., Machado J.C., Bordin M.C., De Wever O., Bruyneel E.A., Moguilevsky N., Grehan N., Porter T.R., Richards F.M., Hruban R.H., Roviello F., Huntsman D., Mareel M., Carneiro F., Caldas C., Seruca R. Identification of CDH1 germline missense mutations associated with functional inactivation of the E- cadherin protein in young gastric cancer probands. Hum Mol Genet 2003; 12: 575–82.Suriano G., Oliveira C., Ferreira P., Machado J.C., Bordin M.C., De Wever O., Bruyneel E.A., Moguilevsky N., Grehan N., Porter T.R., Richards F.M., Hruban R.H., Roviello F., Huntsman D., Mareel M., Carneiro F., Caldas C., Seruca R. Identification of CDH1 germline missense mutations associated with functional inactivation of the E- cadherin protein in young gastric cancer probands. Hum Mol Genet 2003; 12: 575–82.More H., Humar B., Weber W., Ward R., Christian A., Lintott C., Graziano F., Ruzzo A.M., Acosta E., Boman B., Harlan M., Ferreira P., Seruca R., Suriano G., Guilford P. Identification of seven novel germline mutations in the human E-cadherin (CDH1) gene. Hum Mutat 2007; 28: 203–11. doi: 10.1002/humu.9473.More H., Humar B., Weber W., Ward R., Christian A., Lintott C., Graziano F., Ruzzo A.M., Acosta E., Boman B., Harlan M., Ferreira P., Seruca R., Suriano G., Guilford P. Identification of seven novel germline mutations in the human E-cadherin (CDH1) gene. Hum Mutat 2007; 28: 203–11. doi: 10.1002/humu.9473.Frebourg T., Oliveira C., Hochain P., Karam R., Manouvrier S., Graziadio C., Vekemans M., Hartmann A., Baert-Desurmont S., Alexandre C., Lejeune Dumoulin S., Marroni C., Martin C., Castedo S., Lovett M., Winston J., Machado J.C., Attié T., Jabs E.W., Cai J., Pellerin P., Triboulet J.P., Scotte M., Le Pessot F., Hedouin A., Carneiro F., Blayau M., Seruca R. Cleft lip/palate and CDH1/E-cadherin mutations in families with hereditary diffuse gastric cancer. J Med Genet 2006; 43: 138–42. doi: 10.1136/jmg.2005.031385.Frebourg T., Oliveira C., Hochain P., Karam R., Manouvrier S., Graziadio C., Vekemans M., Hartmann A., Baert-Desurmont S., Alexandre C., Lejeune Dumoulin S., Marroni C., Martin C., Castedo S., Lovett M., Winston J., Machado J.C., Attié T., Jabs E.W., Cai J., Pellerin P., Triboulet J.P., Scotte M., Le Pessot F., Hedouin A., Carneiro F., Blayau M., Seruca R. Cleft lip/palate and CDH1/E-cadherin mutations in families with hereditary diffuse gastric cancer. J Med Genet 2006; 43: 138–42. doi: 10.1136/jmg.2005.031385.Oliveira C., Senz J., Kaurah P., Pinheiro H., Sanges R., Haegert A., Corso G., Schouten J., Fitzgerald R., Vogelsang H., Keller G., Dwerryhouse S., Grimmer D., Chin S.F., Yang H.K., Jackson C.E., Seruca R., Roviello F., Stupka E., Caldas C., Huntsman D. Germline CDH1 deletions in hereditary diffuse gastric cancer families. Hum Mol Genet. 2009 May 1; 18(9): 1545–55. doi: 10.1093/hmg/ddp046.Oliveira C., Senz J., Kaurah P., Pinheiro H., Sanges R., Haegert A., Corso G., Schouten J., Fitzgerald R., Vogelsang H., Keller G., Dwerryhouse S., Grimmer D., Chin S.F., Yang H.K., Jackson C.E., Seruca R., Roviello F., Stupka E., Caldas C., Huntsman D. Germline CDH1 deletions in hereditary diffuse gastric cancer families. Hum Mol Genet. 2009 May 1; 18(9): 1545–55. doi: 10.1093/hmg/ddp046.Humar B., Graziano F., Cascinu S., Catalano V., Ruzzo A.M., Magnani M., Toro T., Burchill T., Futschik M.E., Merriman T., Guilford P. Association of CDH1 haplotypes with susceptibility to sporadic diffuse gastric cancer. Oncogene 2002; 21: 8192–5. doi: 10.1038/sj.onc.1205921.Humar B., Graziano F., Cascinu S., Catalano V., Ruzzo A.M., Magnani M., Toro T., Burchill T., Futschik M.E., Merriman T., Guilford P. Association of CDH1 haplotypes with susceptibility to sporadic diffuse gastric cancer. Oncogene 2002; 21: 8192–5. doi: 10.1038/sj.onc.1205921.Nasri S., More H., Graziano F., Ruzzo A., Wilson E., Dunbier A., McKinney C., Merriman T., Guilford P., Magnani M., Humar B. A novel diffuse gastric cancer susceptibility variant in E-cadherin (CDH1) intron 2: a case control study in an Italian population. BMC Cancer. 2008 May 15; 8: 138. doi: 10.1186/1471-2407-8-138.Nasri S., More H., Graziano F., Ruzzo A., Wilson E., Dunbier A., McKinney C., Merriman T., Guilford P., Magnani M., Humar B. A novel diffuse gastric cancer susceptibility variant in E-cadherin (CDH1) intron 2: a case control study in an Italian population. BMC Cancer. 2008 May 15; 8: 138. doi: 10.1186/1471-2407-8-138.Schrader K.A., Masciari S., Boyd N., Wiyrick S., Kaurah P., Senz J., Burke W., Lynch H.T., Garber J.E., Huntsman D.G. Hereditary diffuse gastric cancer: association with lobular breast cancer. Fam Cancer. 2008; 7: 73–82.Schrader K.A., Masciari S., Boyd N., Wiyrick S., Kaurah P., Senz J., Burke W., Lynch H.T., Garber J.E., Huntsman D.G. Hereditary diffuse gastric cancer: association with lobular breast cancer. Fam Cancer. 2008; 7: 73–82.Berx G., Becker K-F., Hofler H., van Roy F. Mutations of the human E-cadherin (CDH1) gene. Hum Mutat 1998; 12: 226–37.Berx G., Becker K-F., Hofler H., van Roy F. Mutations of the human E-cadherin (CDH1) gene. Hum Mutat 1998; 12: 226–37.Becker K.F., Reich U., Schott C., Becker I., Berx G., van Roy F., Höfler H. Identification of 11 novel tumor-associated E-cadherin mutations. Hum Mutat 1998; 13: 171–5. doi: 10.1002/(SICI)1098-1004-(1999)13:2<171::AID-HUMU14>3.0.CO;2-Z.Becker K.F., Reich U., Schott C., Becker I., Berx G., van Roy F., Höfler H. Identification of 11 novel tumor-associated E-cadherin mutations. Hum Mutat 1998; 13: 171–5. doi: 10.1002/(SICI)1098-1004-(1999)13:2<171::AID-HUMU14>3.0.CO;2-Z.Pharoah P.D., Guilford P., Caldas C. Incidence of gastric cancer and breast cancer in CDH1 (E-cadgerin) mutation carries from hereditary diffuse gastric cancer families. Gastroenterology. 2001; 121(6): 1348–53.Pharoah P.D., Guilford P., Caldas C. Incidence of gastric cancer and breast cancer in CDH1 (E-cadgerin) mutation carries from hereditary diffuse gastric cancer families. Gastroenterology. 2001; 121(6): 1348–53.Tsukanov A.C., Shelygin Iu.A., Kashnikov V.N., Frolov S.A., Liubchenko L.N., Shubin V.P., Karpukhin A.V., Muzaffarova T.A., Pospekhova N.I. Molecular genetic study of hereditary predisposition to diffuse gastric cancer in Russian patients. Vopr Onkol. 2013; 59(5): 580‑4.Tsukanov A.C., Shelygin Iu.A., Kashnikov V.N., Frolov S.A., Liubchenko L.N., Shubin V.P., Karpukhin A.V., Muzaffarova T.A., Pospekhova N.I. Molecular genetic study of hereditary predisposition to diffuse gastric cancer in Russian patients. Vopr Onkol. 2013; 59(5): 580‑4.Seevaratnam R., Coburn N., Cardoso R., Dixon M., Bocicariu A., Helyer L. А systematic review of the indications for genetic testing and prophylactic gastrectomy among patients with hereditary diffuse gastric canser. Gastric Canser. 2012; 15(1): 153–163.Seevaratnam R., Coburn N., Cardoso R., Dixon M., Bocicariu A., Helyer L. А systematic review of the indications for genetic testing and prophylactic gastrectomy among patients with hereditary diffuse gastric canser. Gastric Canser. 2012; 15(1): 153–163.Strong V.E., Gholami S., Shah M.A., Tang L.H., Janjigian Y.Y., Schattner M., Selby L.V., Yoon S.S., Salo-Mullen E., Stadler Z.K., Kelsen D., Brennan M.F., Coit D.G. Total Gastrectomy for Hereditary Diffuse Gastric Cancer at a Single Center: Postsurgical Outcomes in 41 Patients. Ann Surg. 2017 Dec; 266(6): 1006–1012. doi: 10.1097/SLA.0000000000002030.Strong V.E., Gholami S., Shah M.A., Tang L.H., Janjigian Y.Y., Schattner M., Selby L.V., Yoon S.S., Salo-Mullen E., Stadler Z.K., Kelsen D., Brennan M.F., Coit D.G. Total Gastrectomy for Hereditary Diffuse Gastric Cancer at a Single Center: Postsurgical Outcomes in 41 Patients. Ann Surg. 2017 Dec; 266(6): 1006–1012. doi: 10.1097/SLA.0000000000002030.Haverkamp L., van der Sluis P.C., Ausems M.G., van der Horst S., Siersema P.D., Ruurda J.P., Offerhaus G.J., van Hillegersberg R. Prophylactic Laparoscopic Total Gastrectomy with Jejunal Pouch Reconstruction in Patients Carrying a CDH1 Germline Mutation. J Gastrointest Surg. 2015 Dec; 19(12): 2120–5. doi: 10.1007/s11605-015-2963-4.Haverkamp L., van der Sluis P.C., Ausems M.G., van der Horst S., Siersema P.D., Ruurda J.P., Offerhaus G.J., van Hillegersberg R. Prophylactic Laparoscopic Total Gastrectomy with Jejunal Pouch Reconstruction in Patients Carrying a CDH1 Germline Mutation. J Gastrointest Surg. 2015 Dec; 19(12): 2120–5. doi: 10.1007/s11605-015-2963-4.Haverkamp L., Weijs T.J., van der Sluis P.C., van der Tweel I., Ruurda J.P., van Hillegersberg R. Laparoscopic total gastrectomy versus open total gastrectomy for cancer: a systematic review and metaanalysis. Surg Endosc. 2013 May; 27(5): 1509–20. doi: 10.1007/s00464-012-2661-1.Haverkamp L., Weijs T.J., van der Sluis P.C., van der Tweel I., Ruurda J.P., van Hillegersberg R. Laparoscopic total gastrectomy versus open total gastrectomy for cancer: a systematic review and metaanalysis. Surg Endosc. 2013 May; 27(5): 1509–20. doi: 10.1007/s00464-012-2661-1.Chen Y., Kingham K., Ford J.M., Rosing J., Van Dam J., Jeffrey R.B., Longacre T.A., Chun N., Kurian A., Norton J.A. A prospective Study of Total Gastrectomy for CDH1-Positive Hereditary Diffuse Gastric Cancer. Ann Surg Oncol. 2011 Sep; 18(9): 2594–8. doi: 10.1245/s10434-011-1648-9.Chen Y., Kingham K., Ford J.M., Rosing J., Van Dam J., Jeffrey R.B., Longacre T.A., Chun N., Kurian A., Norton J.A. A prospective Study of Total Gastrectomy for CDH1-Positive Hereditary Diffuse Gastric Cancer. Ann Surg Oncol. 2011 Sep; 18(9): 2594–8. doi: 10.1245/s10434-011-1648-9.Blair V., Shaw D., Martin H., Kerr D., Arnold J., Harawira P., MacLeod M., Parry S., Charlton A., Findlay M., Cox B., Guilford P. Hereditary diffuse gastric cancer: diagnosis and management. Cli Gastroenterol Hepatol. 2006; 4: 262–75.Blair V., Shaw D., Martin H., Kerr D., Arnold J., Harawira P., MacLeod M., Parry S., Charlton A., Findlay M., Cox B., Guilford P. Hereditary diffuse gastric cancer: diagnosis and management. Cli Gastroenterol Hepatol. 2006; 4: 262–75.

The authors declare that there are no conflicts of interest present.