Vangala, Deepak B., Ladigan-Badura, Swetlana, Engel, Christoph ORCID: 0000-0002-7247-282X, Hueneburg, Robert, Perne, Claudia, Bucksch, Karolin ORCID: 0000-0003-4586-4032, Nattermann, Jacob, Steinke-Lange, Verena ORCID: 0000-0001-8491-3234, Rahner, Nils, Weitz, Juergen, Kloor, Matthias, Tomann, Judith, Canbay, Ali, Strassburg, Christian, Moeslein, Gabriele, Morak, Monika, Holinski-Feder, Elke, Buettner, Reinhard, Aretz, Stefan ORCID: 0000-0002-5228-1890, Loeffler, Markus, Schmiegel, Wolff, Pox, Christian and Schulmann, Karsten (2021). Early detection of duodenal cancer by upper gastrointestinal-endoscopy in Lynch syndrome. Int. J. Cancer, 149 (12). S. 2052 - 2063. HOBOKEN: WILEY. ISSN 1097-0215

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Abstract

Small bowel cancer (SBC) is the malignancy with the highest standardized incidence ratio in Lynch syndrome (LS) patients. Of all SBCs, about 50% are duodenal cancers (DCs), therefore being accessible by esophago-gastro-duodenoscopy (EGD) for surveillance. We asked whether early detection of DC is possible for LS patients undergoing surveillance by EGD and if surveillance should be limited to specific subgroups. Data for LS patients with DC were retrieved from the registry of the German Consortium for Familial Intestinal Cancer. Patients undergoing active surveillance by EGDs (surveillance group) were compared to those who did not (nonsurveillance group) regarding tumor stage at diagnosis. Union for International Cancer Control stages I-IIA were defined as early stage disease and IIB-IV as advanced stage disease. Statistical analysis was performed using Fisher's exact test. Among 2015 patients with pathogenic variants in any mismatch-repair-gene, 47 patients with 49 DCs were identified. In 10% of cases, patients were under 35 years at diagnosis; family and personal tumor history did not correlate with DC diagnosis. Pathogenic germline variants in MSH6, PMS2 or EPCAM were present in 10% of patients. Statistical analysis could be performed on 13 DC patients in the surveillance group and 14 in the nonsurveillance group. Early detection was possible for 71% of patients in the surveillance group and 29% of patients in the nonsurveillance group (P = .021). Early detection of DC by EGD in LS patients is feasible regardless of family history, mutational status and should start no later than 25 years of age.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Vangala, Deepak B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ladigan-Badura, SwetlanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Engel, ChristophUNSPECIFIEDorcid.org/0000-0002-7247-282XUNSPECIFIED
Hueneburg, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Perne, ClaudiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bucksch, KarolinUNSPECIFIEDorcid.org/0000-0003-4586-4032UNSPECIFIED
Nattermann, JacobUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steinke-Lange, VerenaUNSPECIFIEDorcid.org/0000-0001-8491-3234UNSPECIFIED
Rahner, NilsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weitz, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kloor, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tomann, JudithUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Canbay, AliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Strassburg, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moeslein, GabrieleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Morak, MonikaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holinski-Feder, ElkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buettner, ReinhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aretz, StefanUNSPECIFIEDorcid.org/0000-0002-5228-1890UNSPECIFIED
Loeffler, MarkusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmiegel, WolffUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pox, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schulmann, KarstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-601835
DOI: 10.1002/ijc.33753
Journal or Publication Title: Int. J. Cancer
Volume: 149
Number: 12
Page Range: S. 2052 - 2063
Date: 2021
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1097-0215
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
NONPOLYPOSIS COLORECTAL-CANCER; SMALL-BOWEL CANCER; SURVEILLANCE; GUIDELINES; RISK; MUTATIONS; POLYPOSIS; HNPCCMultiple languages
OncologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60183

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