Photo of Yann ParcProfessional title: Professeur des Universités, Praticien des Hôpitaux (Pu-Ph)

Year of primary qualification: 1999

Current institutions: Department of Digestive Surgery, Hôpital Saint-Antoine; Assistance Publique, Hôpitaux de Paris, Univeristé Pierre et Marie Curie

Title of presentation: Familial polyposis coli and related syndromes (Symposium: Intestinal polyposis)

Learning objectives: to be able to distinguish the different polyposis syndromes, to be aware of their specific risks and surveillance main objectives; for adenomatous polyposis, the objective is to know the different syndrome responsible of these polyposis and their transmission; for familial adenomatous polyposis, the objectives are to know the indication for prophylactic surgery and the available treatments for the different manifestations of the disease.

Clinical/research background

My fundamental research is focused on MSI colorectal tumors prognosis and hereditary predisposition to colorectal cancer. The impact of MSI phenotype on prognosis is now well known and accepted. However, a subgroup of worse prognosis in the MSI phenotype tumors has recently been identified in our group (1). Research of rare causes of hereditary predispositions to colon and rectal cancer represents a great challenge, as not all patients with a family history of colorectal cancer will have a genetic cause identified. Specific variants, mutation on other genes or specific genetic presentations have to explore (2, 3).

In parallel, my clinical research is also focused on the treatments of HNPCC and FAP patients. The identification of HNPCC patients is, for the moment, the most important subject of this syndrome (4) while improvement of prophylactic operation and treatments non-colorectal phenotype in FAP represents new challenges (5-7). This specific focus helps me to develop a close collaboration with all members of the Mallorca group leading to publication of European guidelines.

Treatment of disease predisposing to cancer development is a part of cancer treatment. As a colorectal cancer, treatment of colon and rectal cancer is also a big part of clinical research. Surgical challenges in these treatments are to limit to impact on quality of life without backdraw on oncologic outcome and to treat complications occurring after such treatments (8), and to treat complicated cancer such as T4 lesion and obstructed colon cancer with good oncologic outcomes (9, 10).

Relevant peer-reviewed publications

  1. Dorard C1, de Thonel A, Collura A, Marisa L, Svrcek M, Lagrange A, Jego G, Wanherdrick K, Joly AL, Buhard O, Gobbo J, Penard-Lacronique V, Zouali H,Tubacher E, Kirzin S, Selves J, Milano G, Etienne-Grimaldi MC, Bengrine-Lefèvre L, Louvet C, Tournigand C, Lefèvre JH, Parc Y, Tiret E, Fléjou JF, Gaub MP,Garrido C, Duval A. Expression of a mutant HSP110 sensitizes colorectal cancer cells to chemotherapy and improves disease prognosis. Nat Med. 2011 Sep 25;17(10):1283-9.
  2. Sourrouille I, Coulet F, Lefevre JH, Colas C, Eyries M, Svrcek M, Bardier-Dupas A, Parc Y, Soubrier F. Somatic mosaicism and double somatic hits can lead to MSI colorectal tumors. Fam Cancer. 2013 Mar;12(1):27-33.
  3. Mongin C, Coulet F, Lefevre JH, Colas C, Svrcek M, Eyries M, Lahely Y, Fléjou JF, Soubrier F, Parc Y. Unexplained polyposis: a challenge for geneticists, pathologists and gastroenterologists. Clin Genet. 2012 Jan;81(1):38-46.
  4. Canard G, Lefevre JH, Colas C, Coulet F, Svrcek M, Lascols O, Hamelin R, Shields C, Duval A, Fléjou JF, Soubrier F, Tiret E, Parc Y. Screening for Lynch syndrome in colorectal cancer: are we doing enough? Ann Surg Oncol. 2012 Mar;19(3):809-16.
  5. Parc Y, Desaint B, Fléjou JF, Lefèvre JH, Serfaty L, Vienne A, Kotti S, Simon T, Tiret E. The effect of ursodesoxycholic acid on duodenal adenomas in familial adenomatous polyposis: a prospective randomized placebo-control trial. Colorectal Dis. 2012 Jul;14(7):854-60.
  6. Nieuwenhuis MH, Lefevre JH, Bülow S, Järvinen H, Bertario L, Kernéis S, Parc Y, Vasen HF. Family history, surgery, and APC mutation are risk factors for desmoid tumors in familial adenomatous polyposis: an international cohort study. Dis Colon Rectum. 2011 Oct;54(10):1229-34.
  7. Hor T, Zalinski S, Lefevre JH, Shields C, Attal E, Tiret E, Parc Y. Feasibility of laparoscopic restorative proctocolectomy without diverting stoma. Dig Liver Dis. 2012 Feb;44(2):118-22.
  8. Pitel S, Lefèvre JH, Tiret E, Chafai N, Parc Y. Redo coloanal anastomosis: a retrospective study of 66 patients. Ann Surg. 2012 Nov;256(5):806-10; discussion 810-1.
  9. 9. Eveno C, Lefevre JH, Svrcek M, Bennis M, Chafai N, Tiret E, Parc Y. Oncologic results after multivisceral resection of clinical T4 tumors. Surgery. 2014 Jun 19. pii: S0039-6060(14)00134-2. doi: 10.1016/j.surg.2014.03.040.
  10. Chéreau N, Lefevre JH, Lefrancois M, Chafai N, Parc Y, Tiret E. Management of malignant left colonic obstruction: is an initial temporary colostomy followed by surgical resection a better option? Colorectal Dis. 2013 Nov;15(11):e646-53. doi: 10.1111/codi.12335.

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