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Oesophagus diseases

Karthik Ravi 1

Affiliations

1 Mayo, None, United States of America

Summary

AI Generated

The speaker reviewed DDW abstracts on oesophageal disorders, highlighting evidence that normal Flip can rule out significant motility abnormalities, TissueCipher SP9 may improve surveillance strategies for nondysplastic Barrett's oesophagus, neoplastic recurrence after endoscopic eradication therapy is uncommon, etrasimod showed promise in eosinophilic esophagitis, and vonoprazan demonstrated rapid and durable improvement in non-erosive reflux disease.

In 558 patients who underwent manometry and Flip, the speaker reported that over 90% with a normal Flip had no significant motility abnormality, and 89% with obstruction and weak contractile response had conclusive EGJ outflow obstruction, supporting Flip as a screening tool and confirmatory test.
In a 699-patient Barrett's oesophagus cohort, TissueCipher SP9 at index endoscopy improved appropriateness of surveillance recommendations compared to guidelines and real world care, the speaker stated, reducing under-treatment of patients who progressed and overuse of endoscopy in those who did not.
Among 152 patients who achieved complete eradication of intestinal metaplasia after endoscopic eradication therapy, neoplastic recurrence was rare at 1.4 per 100 person-years over a mean 87-month follow-up, the speaker reported, with most recurrence within 13 months and all 13 recurrences successfully re-treated.
In the phase 2 VOYAGE study of 108 eosinophilic esophagitis patients, etrasimod 2mg daily met the primary endpoint of decreased peak eosinophil count at 16 weeks and showed durable histologic, endoscopic, and symptomatic improvement to 52 weeks with no serious treatment-related adverse events, the speaker stated.
In 772 patients with non-erosive reflux disease, vonoprazan 10 and 20mg daily met the primary endpoint of increased percentage of heartburn-free days at 4 weeks, with rapid onset as soon as 1 day and durable benefit such that over 75% of patients reported over 75% of days heartburn-free after 20 weeks, the speaker reported.

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Abstract

Event

UEG Week Vienna 2024

Topics

Endoscopy Gut Microbiota IBD Oesophagus Stomach & H. Pylori

Session

Best of DDW

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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COLORECTAL CANCER SURVEILLANCE PROGRAM IN LYNCH SYNDROME: A CLINICAL AUDIT IN A REFERENCE CENTER

Fabio Correia

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Panel discussion: Therapy update - EoE

Summary

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Abstract

Event

UEG Week Berlin 2025

Topics

Mechanisms & Personalised Medicine Small Intestine & Nutrition Oesophagus Paediatrics

Session

Therapy update: EoE

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Emma V. Carrington

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Fabio Correia

UEG Presentation

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Butt problems

Emma V. Carrington 1

Affiliations

1 University of North Carolina / NCRBSI, London, United Kingdom

Summary

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Abstract

Event

UEG Week Berlin 2025

Topics

Colorectal Hepatobiliary Primary Care

Session

Cross-cutting: Management changes in high prevalence problems

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Emma V. Carrington

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Marco Vincenzo Lenti

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Luc Biedermann

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Alfredo J. Lucendo

COLORECTAL CANCER SURVEILLANCE PROGRAM IN LYNCH SYNDROME: A CLINICAL AUDIT IN A REFERENCE CENTER

Fabio Correia

UEG Presentation

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Europe’s malabsorption game-changer: What every doctor must know!

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Europe’s malabsorption game-changer: What every doctor must know!

Marco Vincenzo Lenti 1

Affiliations

1 Fondazione IRCCS Policlinico San Matteo, University of Pavia, Alessandria, Italy

Summary

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Abstract

Event

UEG Week Berlin 2025

Topics

Small Intestine & Nutrition Standards & Guidelines

Session

From guidelines to clinical practice: Bringing guidelines to life - Tackling malabsorption in clinical practice

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Alfredo J. Lucendo

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Fabio Correia

UEG Presentation

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Biologic drugs

Luc Biedermann 1

Affiliations

1 USZ Zürich, Zürich, Switzerland

Summary

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Abstract

Event

UEG Week Berlin 2025

Topics

Mechanisms & Personalised Medicine Small Intestine & Nutrition Oesophagus Paediatrics

Session

Therapy update: EoE

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Emma V. Carrington

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Luc Biedermann

Diet: 1,6, or more?

Alfredo J. Lucendo

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Fabio Correia

UEG Presentation

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Diet: 1,6, or more?

Alfredo J. Lucendo 1

Affiliations

1 Hospital General de Tomelloso, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Tomelloso, Spain

Summary

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Abstract

Event

UEG Week Berlin 2025

Topics

Mechanisms & Personalised Medicine Small Intestine & Nutrition Oesophagus Paediatrics

Session

Therapy update: EoE

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Emma V. Carrington

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Marco Vincenzo Lenti

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Luc Biedermann

Diet: 1,6, or more?

Alfredo J. Lucendo

COLORECTAL CANCER SURVEILLANCE PROGRAM IN LYNCH SYNDROME: A CLINICAL AUDIT IN A REFERENCE CENTER

Fabio Correia

UEG Poster

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COLORECTAL CANCER SURVEILLANCE PROGRAM IN LYNCH SYNDROME: A CLINICAL AUDIT IN A REFERENCE CENTER

Nuno Gonçalves 1, Francisca Côrte-Real 2, Fabio Correia 3, Ângela Domingues 4, Mónica Garrido 1, Catarina Lopes Brandão 1

Affiliations

1 Portuguese Oncology Institute of Porto, Porto, Portugal

2 Hospital do Divino Espírito Santo de Ponta Delgada, EPER, Lagoa, São Miguel, Portugal

3 Hospital Prof. Dr. Fernando Fonseca, Peniche, Portugal

4 ULS Viseu Dão Lafões, Mondim da Beira, Portugal

Summary

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Abstract

Introduction

Lynch syndrome (LS) is a hereditary condition associated with an increased risk of early colorectal cancer (CRC), due to mutations in DNA mismatch repair (MMR) genes, accounting for 3-5% of all CRC. High-definition screening colonoscopies in specialized centers reduce CRC mortality in this setting.

Aims & Methods

We conducted a clinical audit in a large cohort of these patients, ultimately to enhance the quality of care provided. We performed a retrospective evaluation of the clinical characteristics and risk factors of LS patients under surveillance at our reference center. CRC surveillance program includes colonoscopy every 2 years, starting at ages 20–25 for MLH1/MSH2 carriers and 30–35 for MSH6/PMS2 carriers. We further analyzed compliance to surveillance protocol and its clinical outcomes – our primary endpoint was mortality rate due to CRC and secondary endpoints were time to first advanced colorectal lesion and CRC staging at diagnosis.

Results

A total of 508 patients were included (44% MSH2, 23% MLH1, 20% MSH6, and 13% PMS2). The mean age at surveillance initiation was 44.4 years, with 35.6% starting after the diagnosis of a Lynch syndrome-associated neoplasia. The mean surveillance duration was 5.6 years. Each patient underwent an average of four colonoscopies, with 50% performed within the recommended surveillance intervals.
During the follow-up period, 35 patients were diagnosed with CRC, with a mean time to first advanced colorectal polyp of 3.7 years and for the first CRC diagnosis of 4.8 years. Having any colonoscopy outside the established interval was not associated with higher CRC incidence (p = 0,647). CRC cases diagnosed prior to surveillance initiation (n=143) were more advanced (58.1% stage ≥ II) and were treated with segmental colectomy in 80% of cases. In contrast, CRC cases diagnosed during surveillance (n=48) were detected at earlier stages (64.6% Tis/T1) and managed with endoscopic resection (29%) or total colectomy (56%) (p < 0.001).
The incidence of CRC was higher in MLH1/MSH2 carriers compared to MSH6/PMS2 carriers (36% vs. 22%, p = 0.0020). The mean age at first CRC diagnosis was 45.6 years for MLH1/MSH2 carriers and 49.9 years for MSH6/PMS2 carriers (p = 0.053). The CRC-related mortality rate was 0.6% (n=3), all cases diagnosed before surveillance initiation.

Conclusion

Although adherence to the CRC surveillance program in LS patients can be optimized, our findings underscore its importance in specialized reference centers. Surveillance was associated with earlier CRC detection, less invasive therapeutic approaches, and reduced CRC-related mortality. Our results also show a lower incidence of CRC and an higher age at first CCR diagnosis in MSH6/PMS2 carriers, strengthening the personalized surveillance recommendations dependent on gene specificities.

References

Castillo-Iturra, J., Sánchez, A. and Balaguer, F. (2024) ‘Colonoscopic surveillance in Lynch Syndrome: Guidelines in perspective’, Familial Cancer [Preprint]
del Carmen, G. et al. (2023) ‘Colorectal surveillance outcomes from an institutional longitudinalcohort of Lynch syndrome carriers’, Frontiers in Oncology, 13
Kastrinos, F. et al. (2021) ‘Gene-specific variation in colorectal cancer surveillance strategies for Lynch syndrome’, Gastroenterology, 161(2)

Conference

UEG Week Berlin 2025

Topics

Colorectal

Submission format

Abstract

Session

LOWER GI (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Panel discussion: Therapy update - EoE

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Emma V. Carrington

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Marco Vincenzo Lenti

Biologic drugs

Luc Biedermann

Diet: 1,6, or more?

Alfredo J. Lucendo

COLORECTAL CANCER SURVEILLANCE PROGRAM IN LYNCH SYNDROME: A CLINICAL AUDIT IN A REFERENCE CENTER

Fabio Correia

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