Effectiveness of a surveillance program of upper endoscopy for upper gastrointestinal cancers in Lynch syndrome patients Journal Article


Authors: Ceravolo, A. H.; Yang, J. J.; Latham, A.; Markowitz, A. J.; Shia, J.; Mermelstein, J.; Calo, D.; Gerdes, H.; Ludwig, E.; Schattner, M. A.; Stadler, Z. K.; Kantor, E.; Du, M.; Mendelsohn, R. B.
Article Title: Effectiveness of a surveillance program of upper endoscopy for upper gastrointestinal cancers in Lynch syndrome patients
Abstract: Background and aims: Lynch syndrome (LS) is the most common cause of hereditary colorectal cancer and is associated with an increased lifetime risk of gastric and duodenal cancers of 8–16% and 7%, respectively; therefore, we aim to describe an esophagogastroduodenoscopy (EGD) surveillance program for upper gastrointestinal (GI) precursor lesions and cancer in LS patients. Methods: Patients who either had positive genetic testing or met clinical criteria for LS who had a surveillance EGD at our institution from 1996 to 2017 were identified. Patients were included if they had at least two EGDs or an upper GI cancer detected on the first surveillance EGD. EGD and pathology reports were extracted manually. Results: Our cohort included 247 patients with a mean age of 47.1 years (SD 12.6) at first EGD. Patients had a mean of 3.5 EGDs (range 1–16). Mean duration of follow-up was 5.7 years. Average interval between EGDs was 2.3 years. Surveillance EGD detected precursor lesions in 8 (3.2%) patients, two (0.8%) gastric cancers and two (0.8%) duodenal cancers. Two interval cancers were diagnosed: a duodenal adenocarcinoma was detected 2 years, 8 months after prior EGD and a jejunal adenocarcinoma was detected 1 year, 9 months after prior EGD. Conclusions: Our data suggest that surveillance EGD is a useful tool to help detect precancerous and cancerous upper GI lesions in LS patients. To our knowledge, this is the first study to examine a program of surveillance EGDs in LS patients. More data are needed to determine the appropriate surveillance interval. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Keywords: hereditary nonpolyposis colorectal cancer; gastric cancer; duodenal cancer
Journal Title: International Journal of Colorectal Disease
Volume: 37
Issue: 1
ISSN: 0179-1958
Publisher: Springer  
Date Published: 2022-01-01
Start Page: 231
End Page: 238
Language: English
DOI: 10.1007/s00384-021-04053-y
PUBMED: 34698909
PROVIDER: scopus
PMCID: PMC8760159
DOI/URL:
Notes: Article -- Export Date: 1 February 2022 -- Source: Scopus
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MSK Authors
  1. Hans Gerdes
    176 Gerdes
  2. Arnold J Markowitz
    139 Markowitz
  3. Zsofia Kinga Stadler
    393 Stadler
  4. Emmy Ludwig
    51 Ludwig
  5. Jinru Shia
    720 Shia
  6. Mark Schattner
    169 Schattner
  7. Delia   Calo
    10 Calo
  8. Elizabeth David Kantor
    41 Kantor
  9. Mengmeng   Du
    75 Du
  10. Alicia Latham
    60 Latham
  11. Janie Yang
    1 Yang