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Panel discussion: HCC - all you need to know

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Panel discussion: HCC - all you need to know

Summary

AI Generated

This panel discussion addressed practical challenges in hepatocellular carcinoma screening, prevention, and treatment selection, emphasizing the need for individualized decision-making in tumor boards and the evolving role of combination therapies.

The speaker stated that the majority of patients are no longer eligible for ultrasound-based screening and require CT or MRI, increasing costs and medical burden; in clinical practice, the speaker uses the Galad score with a threshold of 12.8 to identify high-risk patients.
Lifestyle modification including Mediterranean diet, regular exercise, and avoiding sedentarism was described by the speaker as capable of changing disease progression and preventing liver diseases including liver cancer, with the speaker advocating for liver rehabilitation programs and prescribed exercise.
The speaker reported that three positive phase 3 trials of TACE plus immunotherapy met their primary endpoint of progression-free survival and showed consistently high response rates, but overall survival data are needed before it becomes standard of care; the combination may be considered for young, fit patients seeking downstaging for transplant.
In transplant evaluation, the speaker stated that EASL recommends an AFP threshold of 500 ng/mL after all treatments, and the speaker noted that Germany has restrictions requiring evaluation at disease start, limiting downstaging options.
The speaker expressed extreme caution using checkpoint inhibitors in patients with autoimmune hepatitis, preferring tyrosine kinase inhibitors as first choice, and noted that bevacizumab should be avoided if recent variceal banding was performed, though other effective options are now available.

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Abstract

Event

UEG Postgraduate Teaching Programme Berlin 2025

Topics

Digestive Oncology Hepatobiliary

Session

Hepatocellular carcinoma: All you need to know

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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When to call the surgeon?

Bas P.L. Wijnhoven

Early versus delayed endoscopic necrosectomy (Complete Session)

RADIOLOGICAL REMISSION IN PERIANAL FISTULIZING CROHN’S DISEASE: BASELINE MRI PREDICTORS AND IMPACT ON CLINICAL OUTCOMES

Monia Fekih

Update on hepatorenal syndrome

Raj Mookerjee

Treating T2D und MASLD in 2025

Jörn Schattenberg

ACLF: When to be concerned?

Christiana Graf

UEG Presentation

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When to call the surgeon?

Bas P.L. Wijnhoven 1

Affiliations

1 Erasmus MC Rotterdam Dept. of Surgery, Rotterdam, Netherlands

Summary

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Abstract

Event

UEG Week Berlin 2025

Topics

Endoscopy Nurses Paediatrics Surgery

Session

Crash course: Foreign bodies

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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When to call the surgeon?

Bas P.L. Wijnhoven

Early versus delayed endoscopic necrosectomy (Complete Session)

RADIOLOGICAL REMISSION IN PERIANAL FISTULIZING CROHN’S DISEASE: BASELINE MRI PREDICTORS AND IMPACT ON CLINICAL OUTCOMES

Monia Fekih

Update on hepatorenal syndrome

Raj Mookerjee

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Jörn Schattenberg

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UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Early versus delayed endoscopic necrosectomy (Complete Session)

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Early versus delayed endoscopic necrosectomy (Complete Session)

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Abstract

Event

UEG Week Berlin 2025

Topics

Endoscopy

Session

Early versus delayed endoscopic necrosectomy

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

When to call the surgeon?

Bas P.L. Wijnhoven

Early versus delayed endoscopic necrosectomy (Complete Session)

RADIOLOGICAL REMISSION IN PERIANAL FISTULIZING CROHN’S DISEASE: BASELINE MRI PREDICTORS AND IMPACT ON CLINICAL OUTCOMES

Monia Fekih

Update on hepatorenal syndrome

Raj Mookerjee

Treating T2D und MASLD in 2025

Jörn Schattenberg

ACLF: When to be concerned?

Christiana Graf

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

RADIOLOGICAL REMISSION IN PERIANAL FISTULIZING CROHN’S DISEASE: BASELINE MRI PREDICTORS AND IMPACT ON CLINICAL OUTCOMES

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RADIOLOGICAL REMISSION IN PERIANAL FISTULIZING CROHN’S DISEASE: BASELINE MRI PREDICTORS AND IMPACT ON CLINICAL OUTCOMES

Sarra Laabidi 1, Amal Ghamougui 1, DONIA GOUIAA 1, sahar chtioui 1, Nadia Ben Mustapha 1, Meriem Serghini Ep Ghachem 1, Asma Labidi 1, Monia Fekih 1

Affiliations

1 Rabta Hospital, Tunis, Tunisia

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Abstract

Introduction

Deep remission in complex perianal fistulizing Crohn’s disease (PFCD) is defined by both clinical and radiological remission. As the ultimate therapeutic goal for this condition, deep remission requires thorough assessment. MRI is the gold standard for evaluating complex perianal involvement.

Aims & Methods

Our aim was to identify baseline MRI factors linked to deep remission in PFCD and assess its impact on clinical outcomes. All patients with complex PFCD treated with anti-TNF-α agents at the gastroenterology department underwent baseline MRI and clinical evaluation. Radiological assessment included the number and type of fistula tracts (per Parks classification), presence/size of pelvic collections, horseshoe tracts (encircling more than 75% of the anal circumference), and rectal wall thickening. The Van Assche score was calculated. Follow-up MRIs were obtained only after clinical remission to assess radiological remission.

Results

Out of 105 patients, 80 were included in the study (male-to-female ratio: 1.33), with a mean age of 32.35 years. On average, patients had 1.7 fistula tracts (range: 1–6), with trans-sphincteric fistulas accounting for 65% of cases. Specific subtypes included ano-vulvar tracts in 8 women (9.5%), rectovaginal in 5 patients (6%), and anorectal tracts extending to the scrotum in 2 men (2.4%). Pelvic collections were present in 14 individuals (16.7%), averaging 23.8 mm in size. Horseshoe-shaped tracts were identified in 19 patients (22.6%), and rectal wall thickening greater than 3 mm was seen in 49 (58.3%). The mean Van Assche MRI score was 14.9. All patients underwent seton placement. The majority (88.1%) received infliximab, while the remainder were treated with adalimumab. Clinical remission was achieved after a mean of 5.8 months. Radiological remission occurred in 24 patients (28.6%). Presence of horseshoe tracts (p=0.013) and Van Assche scores more than 14 (p=0.027) were significantly associated with failure to reach radiological remission. These factors were confirmed as independent predictors by multivariate analysis. Among those who initially achieved radiological remission, 13 experienced recurrence during an average follow-up of 65.8 months. Radiological remission was associated with improved outcomes: recurrence-free survival rates were 81.3% at 1 year, 62.7% at 3 years, and 50.1% at 5 years, compared to 62.2%, 35.8%, and 23.2%, respectively, in patients with clinical remission but without radiological remission.

Conclusion

Deep remission was achieved in about one-third of PFCD patients following clinical remission. Horseshoe fistulas and Van Assche score more than 14 predict failure to reach this goal, correlating with worse long-term outcomes. These findings support the Top-Class classification designating such cases as unsuitable for curative repair, emphasizing symptom control instead.

Event

UEG Week Berlin 2025

Topics

IBD

Submission format

Abstract

Session

Treatment of fistulas in Crohn's disease

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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When to call the surgeon?

Bas P.L. Wijnhoven

Early versus delayed endoscopic necrosectomy (Complete Session)

RADIOLOGICAL REMISSION IN PERIANAL FISTULIZING CROHN’S DISEASE: BASELINE MRI PREDICTORS AND IMPACT ON CLINICAL OUTCOMES

Monia Fekih

Update on hepatorenal syndrome

Raj Mookerjee

Treating T2D und MASLD in 2025

Jörn Schattenberg

ACLF: When to be concerned?

Christiana Graf

UEG Presentation

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Update on hepatorenal syndrome

Raj Mookerjee 1

Affiliations

1 UCL Institute of Hepatology, University College London, UK, London, United Kingdom

Summary

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Abstract

Event

UEG Week Berlin 2025

Topics

Hepatobiliary

Session

What's new in complications in chronic liver disease in 2025?

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

When to call the surgeon?

Bas P.L. Wijnhoven

Early versus delayed endoscopic necrosectomy (Complete Session)

RADIOLOGICAL REMISSION IN PERIANAL FISTULIZING CROHN’S DISEASE: BASELINE MRI PREDICTORS AND IMPACT ON CLINICAL OUTCOMES

Monia Fekih

Update on hepatorenal syndrome

Raj Mookerjee

Treating T2D und MASLD in 2025

Jörn Schattenberg

ACLF: When to be concerned?

Christiana Graf

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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Treating T2D und MASLD in 2025

Jörn Schattenberg 1

Affiliations

1 Department of Internal Medicine II, Saarland University Medical Center, Homburg, Germany

Summary

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Abstract

Event

UEG Postgraduate Teaching Programme Berlin 2025

Topics

Gut Microbiota Hepatobiliary Mechanisms & Personalised Medicine

Session

Diabetes in GI disorders

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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When to call the surgeon?

Bas P.L. Wijnhoven

Early versus delayed endoscopic necrosectomy (Complete Session)

RADIOLOGICAL REMISSION IN PERIANAL FISTULIZING CROHN’S DISEASE: BASELINE MRI PREDICTORS AND IMPACT ON CLINICAL OUTCOMES

Monia Fekih

Update on hepatorenal syndrome

Raj Mookerjee

Treating T2D und MASLD in 2025

Jörn Schattenberg

ACLF: When to be concerned?

Christiana Graf

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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ACLF: When to be concerned?

Christiana Graf 1

Affiliations

1 LMU Klinikum, Munich, Germany

Summary

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Abstract

Event

UEG Week Berlin 2025

Topics

Colorectal Hepatobiliary Pancreas

Session

Predicting disease severity

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

When to call the surgeon?

Bas P.L. Wijnhoven

Early versus delayed endoscopic necrosectomy (Complete Session)

RADIOLOGICAL REMISSION IN PERIANAL FISTULIZING CROHN’S DISEASE: BASELINE MRI PREDICTORS AND IMPACT ON CLINICAL OUTCOMES

Monia Fekih

Update on hepatorenal syndrome

Raj Mookerjee

Treating T2D und MASLD in 2025

Jörn Schattenberg

ACLF: When to be concerned?

Christiana Graf

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