Enhancing the efficacy of colonoscopy in Lynch syndrome: the search for the holy grail continues
Haanstra and coauthors1 share the results from their randomized controlled trial assessing the impact of proximal colon chromoendoscopy for the detection of neoplasia at baseline and follow-up colonoscopy in patients with Lynch syndrome (LS) performed across 6 centers in the Netherlands. In the trial, indigo carmine chromoendoscopy application in the proximal colon was compared with standard white-light endoscopy (WLE) in 246 mismatch repair gene mutation carriers. Although chromoendoscopy led to a significantly increased median withdrawal time (19 vs 12 minutes), no improvement in the number of patients detected with neoplasia was observed (30% vs 27%).
ConclusionsRobotic resection of the tumor nodule off the external iliac vessels was successfully performed with adequate range of motion provided by the arms and without any complications.Trocar placement should be tailored to the site of surgical interest. Robotic-assisted laparoscopy should be considered as a valid alternative to the traditional open approach, when managing solitary masses in recurrent ovarian cancer patients.
Pancreatic cancer is a rare cancer that carries a poor 5 year survival rate of approximately 5% . Approximately 5% to 10% of individuals with pancreatic cancer report having a closely related family member also being diagnosed with pancreatic cancer . Several known genetic syndromes, such as hereditary breast-ovarian cancer syndrome (HBOC) , Lynch syndrome , familial adenomatous polyposis , familial atypical multiple mole melanoma syndrome , hereditary pancreatitis , Peutz-Jeghers syndrome , and Li-Fraumeni syndrome  are associated with increased risk of pancreatic cancer.
CONCLUSIONS: Universal tumour testing strategies for guiding germline genetic testing of people with incident CRC for LS in Australia are likely to be cost-effective compared with no testing. Universal germline gene panel testing would not currently be cost-effective. PMID: 31595523 [PubMed - as supplied by publisher]
Screening for Lynch syndrome (LS) is routinely performed in patients with endometrial carcinoma. Currently, no screening recommendations exist for LS in precancerous lesions. The study goal was to determine the incidence of abnormal protein expression in endometrioid intraepithelial neoplasia/atypical hyperplasia (EIN/AH). We analyzed mismatch repair (MMR) protein expression by immunohistochemistry in EIN/AH concurrent with MMR-deficient endometrial carcinomas, and in endometrial biopsy/curettage specimens with EIN/AH from an unselected group of patients. Of 63 patients with MMR-deficient endometrial carcinoma, 34 demonstr...
Endoscopy DOI: 10.1055/a-1016-4977ESGE recommends that individuals with Lynch syndrome should be followed in dedicated units that practice monitoring of compliance and endoscopic performance measures.Strong recommendation, low quality evidence, level of agreement 100 %.ESGE recommends starting colonoscopy surveillance at the age of 25 years for MLH1 and MSH2 mutation carriers and at the age of 35 years for MSH6 and PMS2 mutation carriers.Strong recommendation, moderate quality evidence, level of agreement 100 %. ESGE recommends the routine use of high-definition endoscopy systems in individuals with Lynch syndrome. Str...
ConclusionsIO seems to be ineffective in HmGB with somatic mut regardless the onset of diagnosis (newly/recurrent) or type of Hm phenotype. However, germline HmGB may have durable responses to IO. Further investigation is needed to determine the potential antitumor immune response in this population.Legal entity responsible for the studyThe authors.FundingThis work was supported in part by the Sheikh Khalifa Al Nahyan Ben Zayed Institute for Personalized Cancer Therapy, and the MD Anderson Cancer Center Support grant (P30 CA016672) MD Anderson Cancer Center.DisclosureAll authors have declared no conflicts of interest.
ConclusionsOur evaluation indicates that we can accurately determine MSI status in cfDNA samples with a wide range of tumor content.Legal entity responsible for the studyThe authors.FundingIllumina.DisclosureS. Zhang: Full / Part-time employment: Illumina. J.S. LoCoco: Full / Part-time employment: Illumina. A. Mentzer: Full / Part-time employment: Illumina. B.M. Crain: Full / Part-time employment: Illumina. S. Katz: Full / Part-time employment: Illumina. G. Berry: Full / Part-time employment: Illumina. Y. Fu: Full / Part-time employment: Illumina. T. Jiang: Full / Part-time employment: Illumina. C. Zhao: Full / Part-time e...
ConclusionsResults of the Idylla ™ MSI Assay were highly concordant with results of routine tests and lower failure rates were observed. Further advantages are the lack of need for matched normal tissue, the low dependence on pre-analytical conditions, the simplified workflow, the short turnaround times, the automated result inte rpretation, and the very limited hands-on work.Editorial acknowledgementTeams involved in the MSI, Idylla MSI Assay, Colon Rectal Cancer, Multicenter Study.Legal entity responsible for the studyIrblleida.FundingBiocartis.DisclosureX. Matias-guiu: Non-remunerated activity/ies: Biocartis.