Hereditary diffuse gastric cancer: Updated clinical practice guidelines Review


Authors: Blair, V. R.; McLeod, M.; Carneiro, F.; Coit, D. G.; D'Addario, J. L.; van Dieren, J. M.; Harris, K. L.; Hoogerbrugge, N.; Oliveira, C.; van der Post, R. S.; Arnold, J.; Benusiglio, P. R.; Bisseling, T. M.; Boussioutas, A.; Cats, A.; Charlton, A.; Schreiber, K. E. C.; Davis, J. L.; Pietro, M. D.; Fitzgerald, R. C.; Ford, J. M.; Gamet, K.; Gullo, I.; Hardwick, R. H.; Huntsman, D. G.; Kaurah, P.; Kupfer, S. S.; Latchford, A.; Mansfield, P. F.; Nakajima, T.; Parry, S.; Rossaak, J.; Sugimura, H.; Svrcek, M.; Tischkowitz, M.; Ushijima, T.; Yamada, H.; Yang, H. K.; Claydon, A.; Figueiredo, J.; Paringatai, K.; Seruca, R.; Bougen-Zhukov, N.; Brew, T.; Busija, S.; Carneiro, P.; DeGregorio, L.; Fisher, H.; Gardner, E.; Godwin, T. D.; Holm, K. N.; Humar, B.; Lintott, C. J.; Monroe, E. C.; Muller, M. D.; Norero, E.; Nouri, Y.; Paredes, J.; Sanches, J. M.; Schulpen, E.; Ribeiro, A. S.; Sporle, A.; Whitworth, J.; Zhang, L.; Reeve, A. E.; Guilford, P.
Review Title: Hereditary diffuse gastric cancer: Updated clinical practice guidelines
Abstract: Hereditary diffuse gastric cancer (HDGC) is an autosomal dominant cancer syndrome that is characterised by a high prevalence of diffuse gastric cancer and lobular breast cancer. It is largely caused by inactivating germline mutations in the tumour suppressor gene CDH1, although pathogenic variants in CTNNA1 occur in a minority of families with HDGC. In this Policy Review, we present updated clinical practice guidelines for HDGC from the International Gastric Cancer Linkage Consortium (IGCLC), which recognise the emerging evidence of variability in gastric cancer risk between families with HDGC, the growing capability of endoscopic and histological surveillance in HDGC, and increased experience of managing long-term sequelae of total gastrectomy in young patients. To redress the balance between the accessibility, cost, and acceptance of genetic testing and the increased identification of pathogenic variant carriers, the HDGC genetic testing criteria have been relaxed, mainly through less restrictive age limits. Prophylactic total gastrectomy remains the recommended option for gastric cancer risk management in pathogenic CDH1 variant carriers. However, there is increasing confidence from the IGCLC that endoscopic surveillance in expert centres can be safely offered to patients who wish to postpone surgery, or to those whose risk of developing gastric cancer is not well defined. © 2020 Elsevier Ltd
Keywords: practice guideline; stomach neoplasms; stomach tumor; neoplastic syndromes, hereditary; humans; human; hereditary tumor syndrome
Journal Title: Lancet Oncology
Volume: 21
Issue: 8
ISSN: 1470-2045
Publisher: Elsevier Science, Inc.  
Date Published: 2020-08-01
Start Page: e386
End Page: e397
Language: English
DOI: 10.1016/s1470-2045(20)30219-9
PUBMED: 32758476
PROVIDER: scopus
PMCID: PMC7116190
DOI/URL:
Notes: Review -- Export Date: 1 September 2020 -- Source: Scopus
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  1. Daniel Coit
    542 Coit