Endoscopic surveillance in hereditary diffuse gastric cancer – Authors’ reply

Just as longer colonoscopy withdrawal times are associated with higher adenoma detection rates, sufficient time for thorough examination of gastric mucosa might improve the quality of surveillance.4 For these reasons, we propose that the International Gastric Cancer Linkage Consortium of hereditary...

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Bibliographic Details
Published in:The lancet oncology 2023-07, Vol.24 (7), p.e288-e288
Main Authors: Sarvestani, A Leila, Asif, Bilal, Famiglietti, Amber L, Korman, Louis, Heller, Theo, Davis, Jeremy L
Format: Article
Language:English
Subjects:
Adenocarcinoma
Biopsy
Colon
E-cadherin
Endoscopy
Gastrectomy
Gastric cancer
Gastric mucosa
Gastrointestinal surgery
Genetic Predisposition to Disease
Germ-Line Mutation
Humans
Patients
Stomach Neoplasms - genetics
Stomach Neoplasms - surgery
Surveillance
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Summary:Just as longer colonoscopy withdrawal times are associated with higher adenoma detection rates, sufficient time for thorough examination of gastric mucosa might improve the quality of surveillance.4 For these reasons, we propose that the International Gastric Cancer Linkage Consortium of hereditary diffuse gastric cancer investigators consider establishing criteria for expert clinicians and centres. [...]we believe it is inaccurate to state that an age exists at which cancer peaks in these individuals with CDH1 variants, as the literature only reports the median age of gastric cancer diagnosis in families ascertained for the study. In response to Massimiliano di Pietro and colleagues, who have made substantial contributions in the field of endoscopic surveillance in hereditary diffuse gastric cancer,5 we do not advocate for abandoning random mucosal biopsies; instead, we aim to show that occult T1a lesions are an expected finding and that their detection does not need to result in immediate total gastrectomy. Because occult signet ring cells are ubiquitous, the yield of random biopsies should not be the only measure by which we define efficacy of surveillance.
ISSN:1470-2045
1474-5488
DOI:10.1016/S1470-2045(23)00278-4