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CLINICAL FEATURES AND PROGNOSIS OF SPORADIC NEOPLASIAS DETECTED IN ULCERATIVE COLITIS PATIENTS

Noriko Yamamoto 1, Ken Yamashita 1, Yudai Takehara 1, Shin Morimoto 1, Fumiaki Tanino 1, Yuki Kamigaichi 1, Hidenori Tanaka 1, Hidehiko Takigawa 1, Ryo Yuge 1, Yuji Urabe 1, Fumio Shimamoto 2, Shiro Oka 1

Affiliations

1 Hiroshima University Hospital, Hiroshima, Japan

2 Hiroshima Cosmopolitan University, Hiroshima, Japan

Summary

AI Generated

A retrospective study of 141 sporadic neoplasias in 59 UC patients found that those with synchronous multiple lesions had higher 5-year cumulative incidence of metachronous lesions compared to those without synchronous lesions.

Among 141 sporadic neoplasias detected by surveillance colonoscopy in UC patients, 91.5% were adenomas, 3.5% were Tis carcinomas, 1.5% were T1a carcinomas, and 3.5% were T1b carcinomas.
Most sporadic neoplasias (70.9%) occurred outside the UC-affected area, with 61.0% in the right colon, 31.2% in the left colon, and 7.8% in the rectum.
The 5-year cumulative incidence of metachronous multiple sporadic neoplasias was 54.2% in patients with synchronous multiple lesions versus 46.4% in those without.
Histology, size, and background mucosa of initial sporadic neoplasias were not associated with incidence of metachronous lesions.
This study is relevant for gastroenterologists managing surveillance strategies in UC patients, particularly those with multiple synchronous neoplasias.

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Abstract

Introduction

Sporadic neoplasias (SNs) and ulcerative colitis-associated neoplasias (UCANs) can occur in patients with UC. Differences in the characteristics and prognoses between UCANs in patients with UC and SNs in patients without UC have been assessed in numerous previous studies. However, only a few studies have focused on the characteristics and prognoses of SNs in patients with UC. It is important to distinguish between UCANs and SNs, because they have different prognoses and therefore need different treatment strategies.

Aims & Methods

This study aimed to evaluate the clinical features and prognoses of SNs detected in patients with UC, both within and outside the affected area. A total of 141 SNs in 59 patients with UC, which were detected by surveillance colonoscopy (SCS) at Hiroshima University Hospital between January 1999 and December 2021, were included. In our hospital, we perform SCS for UC patients with left-sided or total colitis and with a disease duration of more than 7 years, if possible, in the remission stage. SNs were diagnosed based on their location, endoscopic features, and histopathological findings. The final diagnosis was made by histopathological evaluation of the excised specimens and confirmed by more than one gastrointestinal pathologist. The histopathological diagnosis of SN was made according to the pathological features described in the recent European Crohn's and Colitis Organization and the European Society of Pathology statement on histopathology. Immunohistochemical evaluation of Ki67 and p53 was performed in all cases. SNs, especially sporadic adenomas, have regular neoplastic glands with low amounts of stroma, and rarely have a mixture of benign/dysplastic crypts. Although UCANs sometimes have a surrounding flat area with overexpression of p53, SNs have no such area and have a distinct border between the neoplastic glands and non-neoplastic mucosa. SNs have Ki67 expression mainly in the superficial zone and have low levels of p53 expression.

Results

The mean age at first SN detection was 58.8 years, and the mean duration of UC was 9.9 years. Male patients represented 64.4% of the enrolled patients. The most common type of UC was the total colitis type (47.5%). With regard to their clinical course, approximately half of the patients (49.2%) presented with the relapse-remitting type. Among the 141 SNs, 129 lesions (91.5%) were diagnosed as adenomas, five (3.5%) as Tis carcinomas, two (1.5%) as T1a carcinomas (superficially submucosal invasive carcinoma: <1,000 µm), and five (3.5%) as T1b carcinomas (deeply submucosal invasive carcinoma: ≥1,000 µm). There were 86 (61.0 %) SNs in the right colon, 44 (31.2%) in the left colon, and 11 (7.8%) in the rectum. When classified as outside or within the affected area of UC, 100 (70.9%) SNs occurred outside and 41 (29.1%) within. Most SNs (135 lesions, 95.7%) underwent endoscopic resection, and only six lesions (4.3%) underwent surgical resection. Among the 59 patients included in this study, synchronous SNs occurred in 14 (23.7%), and metachronous multiple SNs occurred in 24 (40.7%) patients. The 5-year cumulative incidence of metachronous multiple SNs was higher in patients with synchronous multiple SNs (54.2%) than in those without (46.4%). The histology, size, and background mucosa of the initial SNs were not associated with the incidence of metachronous SNs in our study.

Conclusion

UC patients with synchronous multiple SNs were at higher risk of developing metachronous multiple SNs and may require close follow-up compared to patients without synchronous SNs.

Conference

UEG Week Copenhagen 2023

Topics

IBD

Submission format

Abstract

Session

PP 05 IBD (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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EFFICACY AND SAFETY OF ELOBIXIBAT COMPARED WITH VITAMIN E IN ADULTS WITH METABOLIC ASSOCIATED STEATOTIC LIVER DISEASE: A 12-WEEK RANDOMIZED DOUBLE BLIND CONTROLLED TRIAL

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RISK AND SURVIVAL OF PANCREATIC DUCTAL ADENOCARCINOMA IN MEN AND WOMEN WITH PATHOGENIC VARIANTS IN BRCA1 OR BRCA2: A NATIONWIDE DUTCH COHORT STUDY

Monique van leerdam

UEG Online Course

not accredited

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A primer in capsule endoscopy

Uwe Seitz

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Overview

Capsule endoscopy (also known as wireless capsule endoscopy or video capsule endoscopy) allows visualisation of the entire small intestine. The procedure has gained popularity because it is not invasive in the same way as traditional endoscopy and it is generally safe and well tolerated. Common indications for the use of capsule endoscopy include occult bleeding and iron-deficiency anaemia, among others.

This online course aims to provide a full introduction to capsule endoscopy, capsule reporting software and the potential complications that may be encountered. Eight cases are used to illustrate the role of capsule endoscopy. The course is based on a presentation (with 35 accompanying slides) given by Uwe Seitz as part of a practical skills training session recorded in June 2015 at the United European Gastroenterology Summer School in Prague, Czech Republic.

Learning objectives

Understand the basics of how to use capsule reporting software.
Know how to deal with the most common complications of capsule endoscopy.
Be aware of the most common indications for capsule endoscopy.
Understand the common pathologies encountered at capsule endoscopy.
Be aware of further investigations that may be recommended following the identification of small-bowel lesions.
Appreciate the need for a thorough knowledge of the patient’s history when interpreting capsule findings.
Know the role of capsule endoscopy in the investigation of patients with iron-deficiency anaemia of unknown origin (both obscure occult bleeding and overt occult bleeding).
Understand the interface between capsule endoscopy and upper digestive endoscopy and enteroscopy.

Target audience

Accredited Gastroenterologists, Gastroenterologists in training, Radiologists and GI surgeons.

Event

A primer in capsule endoscopy

Topics

Endoscopy

Accreditation status

not accredited

Duration

1 hour

Published

2015

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A primer in capsule endoscopy

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Dan Yock Young

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Irsan Hasan

EVALUATING NON-INVASIVE ELIGIBILITY CRITERIA FOR RESMETIROM AND SEMAGLUTIDE IN METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE: REAL-WORLD DATA FROM AN ITALIAN MULTICENTER COHORT

Alessio Aghemo

RISK AND SURVIVAL OF PANCREATIC DUCTAL ADENOCARCINOMA IN MEN AND WOMEN WITH PATHOGENIC VARIANTS IN BRCA1 OR BRCA2: A NATIONWIDE DUTCH COHORT STUDY

Monique van leerdam

UEG Presentation

New

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Summary: Strategies in proctology: From diagnosis to multidisciplinary management

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Summary: Strategies in proctology: From diagnosis to multidisciplinary management

Ugo Grossi 1

Affiliations

1 Humanitas Gavazzeni, Bergamo, Italy

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Abstract

Event

Postgraduate Teaching Programme Barcelona 2026

Topics

Surgery Colorectal

Session

Strategies in proctology: From diagnosis to multidisciplinary management

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

A primer in capsule endoscopy

Uwe Seitz

Summary: Strategies in proctology: From diagnosis to multidisciplinary management

Ugo Grossi

SHORT-TERM GAINS, LONG-TERM CHALLENGES: A PILOT RANDOMIZED CONTROLLED TRIAL FOR TIME-RESTRICTED FEEDING VERSUS CALORIC RESTRICTION IN SIGNIFICANT MASLD

Dan Yock Young

EFFICACY AND SAFETY OF ELOBIXIBAT COMPARED WITH VITAMIN E IN ADULTS WITH METABOLIC ASSOCIATED STEATOTIC LIVER DISEASE: A 12-WEEK RANDOMIZED DOUBLE BLIND CONTROLLED TRIAL

Irsan Hasan

EVALUATING NON-INVASIVE ELIGIBILITY CRITERIA FOR RESMETIROM AND SEMAGLUTIDE IN METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE: REAL-WORLD DATA FROM AN ITALIAN MULTICENTER COHORT

Alessio Aghemo

RISK AND SURVIVAL OF PANCREATIC DUCTAL ADENOCARCINOMA IN MEN AND WOMEN WITH PATHOGENIC VARIANTS IN BRCA1 OR BRCA2: A NATIONWIDE DUTCH COHORT STUDY

Monique van leerdam

UEG Presentation

New

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

SHORT-TERM GAINS, LONG-TERM CHALLENGES: A PILOT RANDOMIZED CONTROLLED TRIAL FOR TIME-RESTRICTED FEEDING VERSUS CALORIC RESTRICTION IN SIGNIFICANT MASLD

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SHORT-TERM GAINS, LONG-TERM CHALLENGES: A PILOT RANDOMIZED CONTROLLED TRIAL FOR TIME-RESTRICTED FEEDING VERSUS CALORIC RESTRICTION IN SIGNIFICANT MASLD

Katelyn Chiu 1, Sophia Lin Delu 1, Jonathan Lee 2, Mastura Binte Salim 3, Nur Halisah Jumat 3, Lei Pheng Yeo 3, Jazleen Leo 3, Melissa Tay 4, Siew Min Ang 4, Amy Tay Yuh Ling 3, Eunice Tan 1, Mark Muthiah 1, Seng Gee Lim 1, Bee Choo Tai 3, Su Lin Lim 4, Dan Yock Young 1

Affiliations

1 National University Hospital, Singapore, Singapore, Singapore

2 National University Health System, Singapore, Singapore, Singapore

3 National University of Singapore, Singapore, Singapore

4 National University Hospital, Singapore, Singapore

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Abstract

Introduction

Weight loss remains the cornerstone therapy for Metabolic dysfunction associated steatotic liver disease (MASLD), for which caloric restriction (CR) is an established strategy. Recently, time restricted feeding (TRF) which aligns food intake with circadian rhythms have shown promise in improving metabolic outcomes. However, comparative data on adherence and weight loss between conventional CR and TRF in MASLD remain limited.

Aims & Methods

We conducted a single-centre pilot randomized controlled trial comparing TRF with conventional CR in adults with significant MASLD fibrosis (defined by liver stiffness by vibration-controlled transient elastography≥7kPa). Forty participants were randomized 1:1 to either daily CR (control) or TRF with an 8-hour feeding window (8:00–16:00) while maintaining equivalent caloric restriction. Dietary adherence was tracked through digital food logs and structured nutritional reviews. Compliance was defined as ≥70% adherence to the prescribed caloric intake (and TRF window for the intervention group. Participants were followed up to 12 months with serial anthropometric and clinical chemistry measurements.

Results

Forty participants (mean age 48.2 ± 12.2 years; 67.5% make, 72.5% Chinese) were enrolled. Baseline metabolic and anthropometric parameters were similar between the two arms (BMI 31.2 vs 30.7 kg/m2, p =0.77; waist circumference 104.6 vs 102.3cm, p=0.59, CAP 315.7 vs 311.2 dB/m, p=0.68, HbA1c 6.2% vs 6.1%, p=0.77). Comorbidities were balanced (diabetes 30%, hypertension 50%, dyslipidaemia 67.5%).
TRF participants achieved greater weight loss than control from Month 1 through Month 6 (p<0.01), with a mean percentage loss at 6 months of -7.7 ± 5.0% versus -2.0 ± 4.9% (p=0.01). The difference attenuated at 12 months (-3.8 ± 4.4% vs -1.6 ± 5.3%, p=0.19), reflecting partial weight gain after the intervention period. Early caloric adherence was comparable between the groups but declined in the TRF arm after 3 months. In the multivariable analysis, TRF independently predicted greater weight loss (p<0.01). Higher caloric adherence correlated with incremental weight reduction (-5% adherence for each 10% weight increase, p<0.01) though the relationship differed by the intervention arm (interaction p<0.01).

Conclusion

TRF led to significantly short-term weight loss compared with standard caloric restriction, and was feasible among adults with significant MASLD. However, adherence waned over time, enforcing that sustained behaviour support is essential to maintain long-term benefits.

Event

UEG Week Barcelona 2026

Topics

Primary Care Hepatobiliary

Submission format

Abstract

Session

Steatotic liver disease: From screening and stigma to therapy

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

A primer in capsule endoscopy

Uwe Seitz

Summary: Strategies in proctology: From diagnosis to multidisciplinary management

Ugo Grossi

SHORT-TERM GAINS, LONG-TERM CHALLENGES: A PILOT RANDOMIZED CONTROLLED TRIAL FOR TIME-RESTRICTED FEEDING VERSUS CALORIC RESTRICTION IN SIGNIFICANT MASLD

Dan Yock Young

EFFICACY AND SAFETY OF ELOBIXIBAT COMPARED WITH VITAMIN E IN ADULTS WITH METABOLIC ASSOCIATED STEATOTIC LIVER DISEASE: A 12-WEEK RANDOMIZED DOUBLE BLIND CONTROLLED TRIAL

Irsan Hasan

EVALUATING NON-INVASIVE ELIGIBILITY CRITERIA FOR RESMETIROM AND SEMAGLUTIDE IN METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE: REAL-WORLD DATA FROM AN ITALIAN MULTICENTER COHORT

Alessio Aghemo

RISK AND SURVIVAL OF PANCREATIC DUCTAL ADENOCARCINOMA IN MEN AND WOMEN WITH PATHOGENIC VARIANTS IN BRCA1 OR BRCA2: A NATIONWIDE DUTCH COHORT STUDY

Monique van leerdam

UEG Presentation

New

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EFFICACY AND SAFETY OF ELOBIXIBAT COMPARED WITH VITAMIN E IN ADULTS WITH METABOLIC ASSOCIATED STEATOTIC LIVER DISEASE: A 12-WEEK RANDOMIZED DOUBLE BLIND CONTROLLED TRIAL

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EFFICACY AND SAFETY OF ELOBIXIBAT COMPARED WITH VITAMIN E IN ADULTS WITH METABOLIC ASSOCIATED STEATOTIC LIVER DISEASE: A 12-WEEK RANDOMIZED DOUBLE BLIND CONTROLLED TRIAL

Cosmas Rinaldi A Lesmana 1,2, Sharon Sandra 3, Anita Kurnia Ilahi 3, Gita Aprilicia 3, Irsan Hasan 1

Affiliations

1 Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia

2 Medistra Hospital, Jakarta, Indonesia

3 Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia

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Abstract

Introduction

Metabolic associated steatotic liver disease (MASLD) has become the emerging cause of chronic liver disease worldwide. However, treatment options remain limited with lifestyle intervention is still the standard of care.¹ Elobixibat, a selective ileal bile acid transporter inhibitor, increases faecal bile acid excretion² and has been associated with improvement lipid and glucose metabolism.^3,4 Its effects on liver steatosis and fibrosis in human remain is still unclear.

Aims & Methods

This was a randomized controlled trial (RCT) assessed the short-term hepatic and metabolic effects of elobixibat compared with vitamin E in adults with MASLD. Adult patients with hepatic steatosis underwent transient elastography examination using FibroScan by Echosens (controlled attenuation parameter (CAP) >260 dB/m) were randomized into three groups: elobixibat 10 mg daily, elobixibat 15 mg daily, or vitamin E 400 mg daily for 12 weeks. Primary outcomes were changes in CAP and liver stiffness measurement (LSM). Secondary outcomes included Fibrosis-4 Index (FIB-4), alanine aminotransferase (ALT), creatinine, lipid profile, and fasting glucose. Both within-group changes and between-group comparisons at week 12 were analysed using appropriate tests.

Results

A total 85 patients completed the treatment arms, where 30 patients received vitamin E 400mg cap once daily, 25 patients received elobixibat 10 mg tablet once daily, and 30 patients recieved elobixibat 15 mg once daily. Baseline demographic, metabolic, dietary, and physical activity characteristics were comparable across groups.
At week 12, CAP showed improvement in the Vitamin E group (310 to 297 dB/m; p=0.202) and elobixibat 10 mg (309 dB/m to 284 dB/m; p=0.083), but not in the elobixibat 15 mg group (302 dB/m to 304 dB/m; p=0.758). LSM significantly improved in elobixibat 15 mg group (6,5 to 5,7 kPa; p=0,017, while favourable trends were seen with vitamin E (5,9 to 4,9 kPa; p=0,178) and elobixibat 10 mg (6,9 to 5,7 kPa; p=0,081). Categorized LSM (F2-F4 vs F0-F1) improved significantly in all groups (vitamin E p=0,031; elobixibat 10 mg p =0,016; elobixibat 15 mg p=0,021).
No significant change was observed in FIB-4, ALT, creatinine, lipid profile, and fasting glucose between groups. Adverse events were more frequent with elobixibat (vitamin E 16,7%, elobixibat 10 mg 44%, elobixibat 15 mg 60%; p=0,003), predominantly was the increased of bowel frequency.

Conclusion

Elobixibat treatment showed a promising short-term effect on liver stiffness improvement, with statistically significant LSM at the 15 mg dose and favourable fibrosis-stage shift across treatment arms. CAP reduction appeared greatest with the 10 mg dose. Treatment was generally well tolerated, although gastrointestinal adverse events were more common in the elobixibat groups. Larger and longer duration studies are warranted to confirm its role in MASLD management.

References

European Association for the Study of the Liver, European Association of the Study of Diabetes, European Association for the Study of Obesity. Tacke F, Horn P, Wai-Sun Wong V, et al. EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. 2024; 81:492-542
Nakajima A, Ishizaki S, Matsuda K, et al. Impact of elobixibat on serum and fecal bile acid levels and constipation symptoms in patients with chronic constipation. J Gastroenterol Hepatol. 2022 May;37(5):883-890.
Matsuyama M, Hirai K, Nonaka H, et al. Effects of elobixibat on constipation and lipid metabolism in patients with moderate to end-stage chronic kidney disease. Front Med. 2022;8:780127.
Hishida Y, Nagai Y, Tsukiyama H, et al. Effects of elobixibat in patients with diabetes and concomitant chronic constipation: an 8-week, prospective, single-center, single-arm study. Adv Ther. 2022 Sep;39(9):4205-4217.

Disclosure

Nothing to disclose

Event

UEG Week Barcelona 2026

Topics

Primary Care Hepatobiliary

Submission format

Abstract

Session

Steatotic liver disease: From screening and stigma to therapy

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

A primer in capsule endoscopy

Uwe Seitz

Summary: Strategies in proctology: From diagnosis to multidisciplinary management

Ugo Grossi

SHORT-TERM GAINS, LONG-TERM CHALLENGES: A PILOT RANDOMIZED CONTROLLED TRIAL FOR TIME-RESTRICTED FEEDING VERSUS CALORIC RESTRICTION IN SIGNIFICANT MASLD

Dan Yock Young

EFFICACY AND SAFETY OF ELOBIXIBAT COMPARED WITH VITAMIN E IN ADULTS WITH METABOLIC ASSOCIATED STEATOTIC LIVER DISEASE: A 12-WEEK RANDOMIZED DOUBLE BLIND CONTROLLED TRIAL

Irsan Hasan

EVALUATING NON-INVASIVE ELIGIBILITY CRITERIA FOR RESMETIROM AND SEMAGLUTIDE IN METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE: REAL-WORLD DATA FROM AN ITALIAN MULTICENTER COHORT

Alessio Aghemo

RISK AND SURVIVAL OF PANCREATIC DUCTAL ADENOCARCINOMA IN MEN AND WOMEN WITH PATHOGENIC VARIANTS IN BRCA1 OR BRCA2: A NATIONWIDE DUTCH COHORT STUDY

Monique van leerdam

UEG Presentation

New

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

EVALUATING NON-INVASIVE ELIGIBILITY CRITERIA FOR RESMETIROM AND SEMAGLUTIDE IN METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE: REAL-WORLD DATA FROM AN ITALIAN MULTICENTER COHORT

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

Not sure what you can access? Learn more about account types.

EVALUATING NON-INVASIVE ELIGIBILITY CRITERIA FOR RESMETIROM AND SEMAGLUTIDE IN METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE: REAL-WORLD DATA FROM AN ITALIAN MULTICENTER COHORT

Nicola Pugliese 1, Davide Polverini 1, Arianna Bertazzoni 1, Federica Cerini 2, Grazie Pennisi 3, Rosa Lombardi 2, Valerio Gullace 1, Stella De Nicola 1, Chiara Masetti 1, Andrea Calogero Paviglianiti 1, Anna Francanzani 2, Mauro Viganò 4, Salvatore Petta 3, Alessio Aghemo 1

Affiliations

1 Humanitas Research Hospital, Rozzano, Italy

2 Università degli Studi di Milano Statale, Milano, Italy

3 Università di Palermo, Palermo, Italy

4 Ospedale Papa Giovanni XXIII, Bergamo, Italy

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Abstract

Introduction

Recently introduced pharmacological therapies for non-cirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with moderate-to-advanced fibrosis (F2-F3), resmetirom and semaglutide, rely on non-invasive tests (NITs) for patient selection. We aimed to quantify eligibility for approved therapies in a large real-world MASLD cohort according to the American Association for the Study of Liver Diseases (AASLD) guidelines for Resmetirom and Semaglutide and Noureddin et al. Expert Panel framework for Resmetirom, and to evaluate concordance, histologic accuracy, and predictors of eligibility.

Aims & Methods

We included 908 consecutive adults with MASLD from four Italian tertiary centres. Demographic, laboratory and vibration-controlled transient elastography (VCTE) data were retrieved from electronic medical records; 175 patients (19.3%) also underwent liver biopsy. Eligibility definitions mirrored published guidance: AASLD (VCTE 8-15 kPa, absence of cirrhosis) and Noureddin et al. (VCTE 10-19.9 kPa, platelets ≥140×10⁹/L, no cirrhosis). Agreement was assessed using Cohen’s κ and McNemar’s test; multivariable logistic regression identified independent predictors of elegibility.

Results

The median age was 62 years and 57% were men. Median BMI was 29.4 kg/m²; obesity and type 2 diabetes (T2D) affected 45.5% and 35.8%, respectively. Median VCTE was 6.3 kPa, and 23.7% of patients had liver stiffness >10 kPa. Overall, 22.6% (205/908) met AASLD eligibility criteria for resmetirom/semaglutide and 12.9% (117/908) met Noureddin et al. eligibility criteria for resmetirom. Eligible patients more frequently had obesity and T2D under both frameworks (p<0.01). Overall agreement between frameworks was 84.3% (κ=0.468), with significant directional discordance (McNemar p<0.0001): 116 patients were eligible only by AASLD and 27 only by Noureddin et al. In multivariable analyses, older age (AASLD OR 1.02, 95% CI 1.00–1.04; Noureddin et al. OR 1.02, 95% CI 1.00–1.05), higher body mass index (AASLD OR 1.05, 95% CI 1.01–1.08; Noureddin et al. OR 1.09, 95% CI 1.04–1.14), and T2D (AASLD OR 2.20, 95% CI 1.56–3.09; Noureddin et al. OR 2.57, 95% CI 1.68–3.93) independently predicted eligibility in both frameworks, while FIB-4 was inversely associated with Noureddin et al. eligibility (OR 0.80, 95% CI 0.66–0.99). Liver biopsy was available in 175 patients; among those with histologically confirmed moderate-to-advanced fibrosis, 52.1% of F2 cases (17/43) and 70% of F3 cases (21/30) met AASLD criteria, whereas 20.9% of F2 cases (9/43) and 50% of F3 cases (15/30) met Noureddin et al. criteria. In the biopsy-anchored cohort, most missed F2-F3 cases had VCTE values below the entry thresholds, whereas a smaller proportion had values above the upper eligibility range or were excluded due to platelet count <140×10⁹/L (Noureddin et al.).

Conclusion

The AASLD and Noureddin et al. frameworks identify overlapping but non-interchangeable populations eligible for approved therapies for MASH. The AASLD approach is broader, whereas the Noureddin et al. framework is more selective but may miss a substantial proportion of histologically confirmed F2-F3 patients. Integrated, stepwise clinical-NIT strategies may improve real-world allocation of MASH therapies.

Disclosure

Travel grant: Gilead and AbbVie. Speaker: Gilead, Gore, Novo Nordisk, AstraZeneca. Advisory Board: Gilead.

Event

UEG Week Barcelona 2026

Topics

Primary Care Hepatobiliary

Submission format

Abstract

Session

Steatotic liver disease: From screening and stigma to therapy

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

A primer in capsule endoscopy

Uwe Seitz

Summary: Strategies in proctology: From diagnosis to multidisciplinary management

Ugo Grossi

SHORT-TERM GAINS, LONG-TERM CHALLENGES: A PILOT RANDOMIZED CONTROLLED TRIAL FOR TIME-RESTRICTED FEEDING VERSUS CALORIC RESTRICTION IN SIGNIFICANT MASLD

Dan Yock Young

EFFICACY AND SAFETY OF ELOBIXIBAT COMPARED WITH VITAMIN E IN ADULTS WITH METABOLIC ASSOCIATED STEATOTIC LIVER DISEASE: A 12-WEEK RANDOMIZED DOUBLE BLIND CONTROLLED TRIAL

Irsan Hasan

EVALUATING NON-INVASIVE ELIGIBILITY CRITERIA FOR RESMETIROM AND SEMAGLUTIDE IN METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE: REAL-WORLD DATA FROM AN ITALIAN MULTICENTER COHORT

Alessio Aghemo

RISK AND SURVIVAL OF PANCREATIC DUCTAL ADENOCARCINOMA IN MEN AND WOMEN WITH PATHOGENIC VARIANTS IN BRCA1 OR BRCA2: A NATIONWIDE DUTCH COHORT STUDY

Monique van leerdam

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RISK AND SURVIVAL OF PANCREATIC DUCTAL ADENOCARCINOMA IN MEN AND WOMEN WITH PATHOGENIC VARIANTS IN BRCA1 OR BRCA2: A NATIONWIDE DUTCH COHORT STUDY

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RISK AND SURVIVAL OF PANCREATIC DUCTAL ADENOCARCINOMA IN MEN AND WOMEN WITH PATHOGENIC VARIANTS IN BRCA1 OR BRCA2: A NATIONWIDE DUTCH COHORT STUDY

Shaad Othman 1, Koen Wijsman 1,2, Aleksander Bogdanski 1, Derk Klatte 1, Inge Lakeman 1, Bert Bonsing 1, Lydia G. Van Der Geest 3, Jeanin van Hooft 1, Marjanka Schmidt 1,4, Monique van leerdam 1,4

Affiliations

1 Leiden University Medical Center, Leiden, Netherlands

2 Mayo Clinic, Jacksonville, United States

3 Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands

4 Netherlands Cancer Institute, Amsterdam, Netherlands

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Abstract

Introduction

Pancreatic ductal adenocarcinoma (PDAC) is highly lethal, and carriers of a pathogenic variant (PV) in BRCA1 or BRCA2 are at increased risk. However, it is uncertain whether their absolute lifetime risk justifies pancreatic cancer surveillance. We estimated the cumulative incidence and survival of PDAC in a nationwide cohort of BRCA1/2 PV carriers.

Aims & Methods

We retrospectively analysed prospectively collected data from the Dutch HEBON study (HEreditary Breast and Ovarian cancer study Netherlands), linked to the national pathology and cancer registries. The cumulative incidence of PDAC was estimated on the age scale with delayed entry and death as a competing risk, at ages 70, 75, and 80 years. This was consequently compared with the recommended 5% lifetime risk threshold for pancreatic cancer surveillance. We estimated cause-specific hazards by gene and sex, standardised incidence ratios (SIR) against the Dutch general population, and overall survival (OS), which we compared with matched general-population PDAC cases.

Results

Of 7049 PV carriers (4472 BRCA1 and 2577 BRCA2), 90 PDAC cases were identified, of which 70 (77.8%) were incident and included in the incidence analyses. The cumulative incidence by age 80 was 2.58% (95% CI 2.01–3.32) overall, 1.97% (1.36–2.85) for BRCA1 PV carriers, and 3.68% (2.62–5.14) for BRCA2 PV carriers. Only male BRCA2 PV carriers exceeded the 5% threshold, reaching a point estimate of 5.37% (95% CI 3.18–8.95) by age 80. The SIR was 3.14 (95% CI 2.12–4.49) in BRCA1 PV carriers and 6.62 (4.66–9.12) in BRCA2 PV carriers. Among all 90 PDAC cases, OS was poor (median 4.7 months; five-year survival 6.7%) and did not differ from matched general-population PDAC cases.

Conclusion

Although the SIR of PDAC is elevated, the absolute risk by age 80 remains below the 5% lifetime risk surveillance threshold for most BRCA1/2 PV carriers, except male BRCA2 PV carriers. These findings do not support surveillance for BRCA1 PV carriers. For BRCA2 PV carriers, particularly men, surveillance may be considered regardless of family history.

Event

UEG Week Barcelona 2026

Topics

Immunology Pancreas Mechanisms & Personalised Medicine Histopathology Hepatobiliary Digestive Oncology

Submission format

Late-Breaking Abstract

Session

Late-Breaking: Advances in liver and pancreatic disease

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

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