Endoscopic Surveillance of Patients With Hereditary Diffuse Gastric Cancer

2012 ◽  
Vol 36 (11) ◽  
pp. 1709-1717 ◽  
Author(s):  
Hiroshi Fujita ◽  
Jochen K.M. Lennerz ◽  
Daniel C. Chung ◽  
Devanshi Patel ◽  
Vikram Deshpande ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Hereditary Diffuse Gastric Cancer ◽  
Endoscopic Surveillance ◽  
Diffuse Gastric Cancer

scholarly journals Single-bite versus double-bite technique for mapping biopsies during endoscopic surveillance for hereditary diffuse gastric cancer: a single-center, randomized trial

Endoscopy ◽  
2020 ◽  
Author(s):  
Apostolos Pappas ◽  
Wei Keith Tan ◽  
William Waldock ◽  
Susan Richardson ◽  
Monika Tripathi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Diagnostic Yield ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Hereditary Diffuse Gastric Cancer ◽  
Endoscopic Surveillance ◽  
Diffuse Gastric Cancer ◽  
Muscularis Mucosa ◽  
Procedural Time ◽  
Surveillance Endoscopy

Abstract Background Endoscopic surveillance is recommended in patients with hereditary diffuse gastric cancer (HDGC) who refuse or want to delay surgery. Because early signet-ring cell carcinoma (SRCC) can be inconspicuous, the current surveillance endoscopy protocol entails 30 random biopsies, which are time-consuming. This study aimed to compare single-bite and double-bite techniques in HDGC surveillance. Methods Between October 2017 and December 2018, consecutive patients referred for HDGC surveillance were prospectively randomized to the single- or double-bite arm. The primary outcome was the diagnostic yield for SRCC foci. Secondary outcomes were: procedural time for random biopsies; comfort score; biopsy size; and quality of specimens, the latter assessed by the presence of muscularis mucosa, crush artifact, and proportion usable for diagnostic assessment. Results 25 patients were randomized to the single-bite arm and 23 to the double-bite arm. SRCC foci were detected in three and four patients in the single- and double-bite arms, respectively (P = 0.70). The procedural time for the double-bite arm (12 minutes, interquartile range [IQR] 4) was significantly shorter than for the single-bite arm (15 minute, IQR 6; P = 0.01), but comfort scores were similar. The size of the biopsies in the double-bite arm was significantly smaller than in single-bite arm (2.5 mm vs. 3.0 mm; P < 0.001) but this did not affect the presence of muscularis mucosa (P = 0.73), artifact level (P = 0.11), and diagnostic utility (P = 0.051). Conclusion For patients undergoing HDGC surveillance, the double-bite technique is significantly faster than the single-bite technique. The diagnostic yield for SRCC and the biopsy quality were similar across both groups.

Outcomes of Endoscopic Surveillance in Individuals With Genetic Predisposition to Hereditary Diffuse Gastric Cancer

2019 ◽  
Vol 157 (1) ◽  
pp. 87-96 ◽  
Author(s):  
Michelle F. Jacobs ◽  
Henry Dust ◽  
Erika Koeppe ◽  
Sandra Wong ◽  
Michael Mulholland ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Genetic Predisposition ◽  
Hereditary Diffuse Gastric Cancer ◽  
Endoscopic Surveillance ◽  
Diffuse Gastric Cancer

scholarly journals CDH1 Gene Mutation Hereditary Diffuse Gastric Cancer Outcomes: Analysis of a Large Cohort, Systematic Review of Endoscopic Surveillance and Secondary Cancer Risk Postulation

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2622
Author(s):  
Matthew G. K. Benesch ◽  
Stuart R. Bursey ◽  
Andrew C. O’Connell ◽  
Morag G. Ryan ◽  
Carrie L. Howard ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Cancer Risk ◽  
Signet Ring Cell ◽  
Endoscopic Biopsy ◽  
Hereditary Diffuse Gastric Cancer ◽  
Endoscopic Surveillance ◽  
Diffuse Gastric Cancer ◽  
Secondary Cancer ◽  
Secondary Cancer Risk

Hereditary diffuse gastric cancer (HDGC) is a rare signet-ring cell adenocarcinoma (SRCC) linked to CDH1 (E-cadherin) inactivating germline mutations, and increasingly other gene mutations. Female CDH1 mutation carriers have additional risk of lobular breast cancer. Risk management includes prophylactic total gastrectomy (PTG). The utility of endoscopic surveillance is unclear, as early disease lacks macroscopic lesions. The current systematic biopsy protocols have unknown efficacy, and other secondary cancer risks are postulated. We conducted a retrospective study of consecutive asymptomatic HDGC patients undergoing PTG, detailing endoscopic, pathologic, and outcome results. A systematic review compared endoscopic biopsy foci detection via random sampling versus Cambridge Protocol against PTG findings. A population-level secondary-cancer-risk postulation among sporadic gastric SRCC patients was completed using the Surveillance, Epidemiology, and End Results database. Of 97 patients, 67 underwent PTG, with 25% having foci detection on random endoscopic biopsy despite 75% having foci on final pathology. There was no improvement in the endoscopic detection rate by Cambridge Protocol. The postulated hazard ratio among sporadic gastric SRCC patients for a secondary colorectal SRCC was three-fold higher, relative to conventional adenocarcinoma patients. Overall, HDGC patients should not rely on endoscopic surveillance to delay PTG, and may have secondary SRCC risks. A definitive determination of actual risk requires collaborative patient outcome data banking.

597 OUTCOMES OF ENDOSCOPIC SURVEILLANCE AND FAMILY HISTORY OF PATIENTS WITH A GENETIC PREDISPOSITION FOR HEREDITARY DIFFUSE GASTRIC CANCER

2020 ◽  
Vol 158 (6) ◽  
pp. S-130
Author(s):  
Robert Hüneburg ◽  
Tim Marwitz ◽  
Dominik Heling ◽  
Tobias Weismüller ◽  
Jan-Frederic Lau ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Family History ◽  
Genetic Predisposition ◽  
Hereditary Diffuse Gastric Cancer ◽  
Endoscopic Surveillance ◽  
Diffuse Gastric Cancer ◽  
History Of

scholarly journals Comparative study of endoscopic surveillance in hereditary diffuse gastric cancer according to CDH1 mutation status

2018 ◽  
Vol 87 (2) ◽  
pp. 408-418 ◽  
Author(s):  
Emma Z. Mi ◽  
Ella Z. Mi ◽  
Massimiliano di Pietro ◽  
Maria O’Donovan ◽  
Richard H. Hardwick ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Comparative Study ◽  
Hereditary Diffuse Gastric Cancer ◽  
Endoscopic Surveillance ◽  
Diffuse Gastric Cancer ◽  
Mutation Status ◽  
Cdh1 Mutation
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