UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

UEG Week Berlin 2025 Recordings Gut Guide online What's new on Gutflix

Trending on Gutflix

Rate for better recommendations!

Your feedback helps us show you more of what you like and less of what you dislike!

More of this!

We will show you more similar content.

Not for me!

We won't suggest this again.

Bookmark!

Save this content for later!

New to myUEG? Create an account! Log In with myUEG account

UEG Presentation

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

Integrative care of gastric cancer: From endoscopic therapies to surgery and chemo/raditherapy

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.

Integrative care of gastric cancer: From endoscopic therapies to surgery and chemo/raditherapy

David G. Graham 1, Bas P.L. Wijnhoven 2

Affiliations

1 University College London Hospital, London, United Kingdom

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

Summary

AI Generated

This educational session covered endoscopic techniques for early gastric cancer resection and multimodal treatment approaches for advanced disease, emphasizing the importance of experience in lesion identification, mastering ESD with appropriate training, and coordinating multidisciplinary care.

The speaker does not use EUS for early gastric cancer staging, stating their own accuracy is around 50%, though some achieve up to 95% accuracy; endoscopists have approximately 80% accuracy identifying lesions amenable to endoscopic therapy through experience.
EMR is limited to lesions under 10 millimeters for dysplastic lesions per guidelines, with approximately one-third of lesions understaged by biopsy; the speaker typically proceeds directly to ESD unless the patient is very frail.
Mastering ESD requires studying lesions through to histopathology outcomes, learning different knife types and traction techniques, practicing on animal models, working with a mentor, and starting with easy accessible lesions before advancing to difficult anatomical locations.
Traction techniques including internal traction and pulley systems improve visibility, speed, and safety; the speaker quotes a 2 to 4% risk of delayed bleeding and perforation and stresses the importance of knowing complication management techniques.
For advanced gastric cancer in the West, the approach is perioperative chemotherapy before and after surgery, achieving approximately 40 to 50% five-year survival in the latest trial, with 20 to 30% experiencing complications.
The speaker states that palliative gastrectomy does not improve survival based on a randomized Asian trial; palliation focuses on systemic therapy including chemotherapy with targeted agents and immunotherapy based on HER2 and PD-L1 expression, with radiotherapy as the mainstay for bleeding and EUS-guided gastroenterostomy offered for obstruction when prognosis exceeds three months.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Event

UEG Postgraduate Teaching Programme Berlin 2025

Session

From risk to recovery: A postgraduate dive into gastric cancer care

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Medical treatment

David Surendran Sanders

GUT MYCOBIOME SIGNATURES PREDICT NEOADJUVANT IMMUNOCHEMOTHERAPY RESPONSE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A MACHINE LEARNING APPROACH WITH EXPERIMENTAL VALIDATION

Shijie Mai

I do underwater resection

Michael John Bourke

Surgical navigation

Suzanne S. Gisbertz

AYA: Adolescents and young adults

Johanna Escher

Treatment of patients with ingestion of caustic substances

Nikolaos Samarentsis

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.

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

Medical treatment

David Surendran Sanders 1

Affiliations

1 Royal Hallamshire Hospital - NHS Trust, Royal Hallamshire Hospital; Sheffield/GB, Sheffield, United Kingdom

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Berlin 2025

Topics

Immunology Small Intestine & Nutrition

Session

Coeliac or non-coeliac enteropathy?

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Medical treatment

David Surendran Sanders

GUT MYCOBIOME SIGNATURES PREDICT NEOADJUVANT IMMUNOCHEMOTHERAPY RESPONSE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A MACHINE LEARNING APPROACH WITH EXPERIMENTAL VALIDATION

Shijie Mai

I do underwater resection

Michael John Bourke

Surgical navigation

Suzanne S. Gisbertz

AYA: Adolescents and young adults

Johanna Escher

Treatment of patients with ingestion of caustic substances

Nikolaos Samarentsis

UEG Presentation

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

GUT MYCOBIOME SIGNATURES PREDICT NEOADJUVANT IMMUNOCHEMOTHERAPY RESPONSE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A MACHINE LEARNING APPROACH WITH EXPERIMENTAL VALIDATION

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.

GUT MYCOBIOME SIGNATURES PREDICT NEOADJUVANT IMMUNOCHEMOTHERAPY RESPONSE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A MACHINE LEARNING APPROACH WITH EXPERIMENTAL VALIDATION

le liu 1, Liping Liang 2, Shijie Mai 3

Affiliations

1 Zhujiang Hospital, Southern Medical University, Guangzhou, China

2 Guangzhou First People's Hospital, Guangzhou, China

3 Nanfang Hospital, Southern Medical University, Guangzhou, China

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Introduction

Esophageal squamous cell carcinoma (ESCC) is associated with poor prognosis despite advances in neoadjuvant immunochemotherapy (NICT). With highly variable treatment responses, identifying reliable predictive biomarkers remains crucial. While gut microbiome influences on immunotherapy efficacy are increasingly recognized, the specific role of the fungal microbiome (mycobiome) in NICT outcomes for ESCC remains unexplored, representing a significant gap in developing personalized treatment strategies.

Aims & Methods

This study aimed to characterize gut mycobiome signatures in ESCC patients and develop fungal biomarker-based predictive models for NICT response. We conducted ITS2 sequencing on 136 fecal samples collected from 68 ESCC patients (pre- and post-NICT) and 19 healthy controls (HC). Patients were stratified as responders (R, n=26) or non-responders (NR, n=42) based on tumor regression grade (TRG) scores. We performed comprehensive analyses of mycobiome diversity, composition, co-occurrence networks, and functional pathways across groups. The Boruta algorithm was employed for feature selection to identify fungal biomarkers, followed by multilayer perceptron (MLP) machine learning with five-fold cross-validation to develop predictive models. Additionally, ESCC xenograft models were established to investigate gut mycobiome-immune interactions through fecal microbiota transplantation (FMT) and targeted fungal manipulation experiments.

Results

ESCC patients demonstrated significant mycobiome dysbiosis compared to healthy controls, characterized by reduced fungal alpha diversity and distinct beta diversity patterns. At baseline, ESCC patients showed enrichment of Rhodotorula minuta, Actinomucor elegans, and several Candida species. Responders exhibited significantly higher baseline fungal diversity than non-responders, with enrichment of Meyerozyma, Candida boidinii, Trichosporon dermatis, and Cryptococcus species, whereas non-responders showed predominance of Saccharomyces, Nakaseomyces, and pathogenic Candida species (C. glabrata, C. parapsilosis, C. albicans). Responders also displayed more complex, stable fungal co-occurrence networks with higher density and clustering coefficients. Post-NICT, both groups showed partial recovery of mycobiome diversity, with significant increases in beneficial fungal taxa. Functional pathway analysis revealed distinct metabolic profiles between responders and non-responders. Using the Boruta algorithm, we identified 23 genus-level and 22 species-level fungal biomarkers that demonstrated high predictive value. The MLP model based on genus-level markers achieved AUCs of 90.2% (training) and 91.9% (test), while the species-level model showed comparable performance. In animal experiments, mice receiving R-FMT exhibited reduced tumor growth and enhanced CD8+ T cell infiltration compared to NR-FMT recipients. Notably, Candida boidinii supplementation synergized with anti-PD-1 therapy, while Saccharomyces depletion enhanced treatment sensitivity.

Conclusion

Our findings establish the gut mycobiome as a powerful predictor of NICT response in ESCC, with machine learning models achieving >90% accuracy using fungal biomarkers. Experimental validation not only confirms mechanistic links between specific fungi and antitumor immunity but also demonstrates that targeted mycobiome modulation can enhance immunotherapy efficacy. This dual approach of prediction and intervention offers a novel framework for precision oncology in ESCC, potentially transforming clinical decision-making and treatment outcomes in this challenging malignancy.

References

1. Li J, Xu J, Zheng Y, et al. Esophageal cancer: Epidemiology, risk factors and screening. Chin J Cancer Res. 2021; 33(5): 535-547.
2. van Hagen P, Hulshof MC, van Lanschot JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012; 366(22): 2074-2084.
3. Schroeder W, Ghadimi M, Schloesser H, et al. Long-Term Outcome After Histopathological Complete Response with and Without Nodal Metastases Following Multimodal Treatment of Esophageal Cancer. Ann Surg Oncol. 2022.
4. Rosner S, Liu C, Forde PM, Hu C. Association of Pathologic Complete Response and Long-Term Survival Outcomes Among Patients Treated With Neoadjuvant Chemotherapy or Chemoradiotherapy for NSCLC: A Meta-Analysis. JTO Clin Res Rep. 2022; 3(9): 100384.
5. Coker OO, Nakatsu G, Dai RZ, et al. Enteric fungal microbiota dysbiosis and ecological alterations in colorectal cancer. Gut. 2019; 68(4): 654-662.
6. Dohlman AB, Klug J, Mesko M, et al. A pan-cancer mycobiome analysis reveals fungal involvement in gastrointestinal and lung tumors. Cell. 2022; 185(20): 3807-3822.
7. Wurster S, Albert ND, Kontoyiannis DP. Candida auris Bloodstream Infection Induces Upregulation of the PD-1/PD-L1 Immune Checkpoint Pathway in an Immunocompetent Mouse Model. Msphere. 2022; 7(2): e81721.

Event

UEG Week Berlin 2025

Topics

Digestive Oncology Gut Microbiota Immunology Mechanisms & Personalised Medicine Oesophagus

Submission format

Abstract

Session

Oncobiome

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Medical treatment

David Surendran Sanders

GUT MYCOBIOME SIGNATURES PREDICT NEOADJUVANT IMMUNOCHEMOTHERAPY RESPONSE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A MACHINE LEARNING APPROACH WITH EXPERIMENTAL VALIDATION

Shijie Mai

I do underwater resection

Michael John Bourke

Surgical navigation

Suzanne S. Gisbertz

AYA: Adolescents and young adults

Johanna Escher

Treatment of patients with ingestion of caustic substances

Nikolaos Samarentsis

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.

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

I do underwater resection

Michael John Bourke 1

Affiliations

1 Westmead Hospital Sydney, Westmead, Australia

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Berlin 2025

Topics

Endoscopy Nurses

Session

Large controversies for large polyps

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Medical treatment

David Surendran Sanders

GUT MYCOBIOME SIGNATURES PREDICT NEOADJUVANT IMMUNOCHEMOTHERAPY RESPONSE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A MACHINE LEARNING APPROACH WITH EXPERIMENTAL VALIDATION

Shijie Mai

I do underwater resection

Michael John Bourke

Surgical navigation

Suzanne S. Gisbertz

AYA: Adolescents and young adults

Johanna Escher

Treatment of patients with ingestion of caustic substances

Nikolaos Samarentsis

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.

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

Surgical navigation

Suzanne S. Gisbertz 1

Affiliations

1 Amsterdam UMC, Amsterdam, Netherlands

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Berlin 2025

Topics

Digestive Oncology Endoscopy Nurses Oesophagus Surgery

Session

What's new in early oesophageal cancer in 2025?

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Medical treatment

David Surendran Sanders

GUT MYCOBIOME SIGNATURES PREDICT NEOADJUVANT IMMUNOCHEMOTHERAPY RESPONSE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A MACHINE LEARNING APPROACH WITH EXPERIMENTAL VALIDATION

Shijie Mai

I do underwater resection

Michael John Bourke

Surgical navigation

Suzanne S. Gisbertz

AYA: Adolescents and young adults

Johanna Escher

Treatment of patients with ingestion of caustic substances

Nikolaos Samarentsis

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.

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

AYA: Adolescents and young adults

Johanna Escher 1

Affiliations

1 Erasmus Medical Center, Rotterdam, Netherlands

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Berlin 2025

Topics

IBD Nurses Paediatrics Primary Care

Session

IBD across all ages

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Medical treatment

David Surendran Sanders

GUT MYCOBIOME SIGNATURES PREDICT NEOADJUVANT IMMUNOCHEMOTHERAPY RESPONSE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A MACHINE LEARNING APPROACH WITH EXPERIMENTAL VALIDATION

Shijie Mai

I do underwater resection

Michael John Bourke

Surgical navigation

Suzanne S. Gisbertz

AYA: Adolescents and young adults

Johanna Escher

Treatment of patients with ingestion of caustic substances

Nikolaos Samarentsis

UEG Presentation

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

Treatment of patients with ingestion of caustic substances

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.

Treatment of patients with ingestion of caustic substances

Aga Charitini 1, Nikolaos Samarentsis 1

Affiliations

1 None, None, Greece

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Berlin 2025

Topics

Nurses

Session

Endoscopic techniques: Emergency and difficult situations

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Medical treatment

David Surendran Sanders

GUT MYCOBIOME SIGNATURES PREDICT NEOADJUVANT IMMUNOCHEMOTHERAPY RESPONSE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A MACHINE LEARNING APPROACH WITH EXPERIMENTAL VALIDATION

Shijie Mai

I do underwater resection

Michael John Bourke

Surgical navigation

Suzanne S. Gisbertz

AYA: Adolescents and young adults

Johanna Escher

Treatment of patients with ingestion of caustic substances

Nikolaos Samarentsis