43 results on '"Sabela Carballal"'
Search Results
2. Prevalence of adenomatous polyposis in a fecal immunochemical test-based colorectal cancer screening program and risk of advanced neoplasia during follow-up
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Angels Pozo, Julio Bernuy, Francesc Balaguer, Isabel Torá, Antoni Castells, Ariadna Sánchez, Sabela Carballal, Maria Pellise, Anna Serradesanferm, Oswaldo Ortiz, Gerhard Jung, Maria Daca, Diana Zaffalon, Teresa Ocaña, Leticia Moreira, Jaume Grau, Jesús-Eduardo Cuellar Monterrubio, and Liseth Rivero-Sánchez
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Adenoma ,medicine.medical_specialty ,Genetic counseling ,Colonic Polyps ,Colonoscopy ,Risk Factors ,Internal medicine ,Prevalence ,Humans ,Medicine ,Cumulative incidence ,Early Detection of Cancer ,Retrospective Studies ,Genetic testing ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Gastroenterology ,Neoplasms, Second Primary ,medicine.disease ,Adenomatous Polyposis Coli ,Fecal Immunochemical Test ,Colorectal Neoplasms ,business ,Follow-Up Studies ,Index Colonoscopy - Abstract
Background Current guidelines recommend genetic counseling and intensive colonoscopy surveillance for patients with ≥ 10 colorectal adenomas based on scarce data. We investigated the prevalence of this condition in a fecal immunochemical test (FIT)-based colorectal (CRC) screening program, and the incidence of metachronous lesions during follow-up. Methods We retrospectively included all FIT-positive participants with ≥ 10 adenomas at index colonoscopy between 2010 and 2018. Surveillance colonoscopies were collected until 2019. Patients with inherited syndromes, serrated polyposis syndrome, total colectomy, or lacking surveillance data were excluded. The cumulative incidence of CRC and advanced neoplasia were analyzed by Kaplan–Meier analysis. Risk factors for metachronous advanced neoplasia were investigated by multivariable logistic regression analysis. Results 215 of 9582 participants (2.2 %) had ≥ 10 adenomas. Germline genetic testing was performed in 92 % of patients with ≥ 20 adenomas, identifying two inherited syndromes (3.3 %). The 3-year cumulative incidence of CRC and advanced neoplasia were 1 % and 16 %, respectively. In 39 patients (24.2 %), no polyps were found on first surveillance colonoscopy. The presence of an advanced adenoma was independently associated with a higher risk of advanced neoplasia at first surveillance colonoscopy (odds ratio 3.91, 95 %CI 1.12–13.62; P = 0.03). Beyond the first surveillance colonoscopy, the risk of metachronous advanced neoplasia was lower. Conclusions The prevalence of ≥ 10 adenomas in a FIT-based CRC screening program was 2.2 %; a small proportion of inherited syndromes were detected, even amongst those with ≥ 20 adenomas. A low rate of post-colonoscopy CRC was observed and the risk of advanced neoplasia beyond the first surveillance colonoscopy tended to progressively decrease throughout successive follow-ups.
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- 2021
3. 173 - POLIPOSIS ADENOMATOSA FAMILIAR, UNA COHORTE RETROSPECTIVA
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Maria José Moreta Saa, Maria Daca-Alvarez, Oswaldo Ortiz, Ariadna Sánchez, Sabela Carballal, Rebeca Moreira, Angelo Brunori, Teresa Ocaña, Leticia Moreira, Francesc Balaguer, and Maria Pellise Urquiza
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Hepatology ,Gastroenterology - Published
- 2023
4. 163 - ¿ES NECESARIO EL CRIBADO DE CÁNCER GÁSTRICO EN EL SÍNDROME DE LYNCH?
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Ariadna Sánchez, Andres Arango, Maria José Moreta, Joan Llach, Mireia Diaz Centeno, Adrià López Fernández, Inmaculada Salces, Gemma Llort, Luis Bujanda Fernández de Piérola, Marta Carrillo-Palau, Goretti Hernández Mesa, Daniel Rodríguez-Alcalde, Maria Dolores Pico Sala, Rodrigo Jover, Carmen Poves, Eva Barreiro-Alonso, Andres Dacal Rivas, Maite Herraiz Bayod, Joaquin Cubiella, Virginia Piñol, Beatriz Peñas, Lorena Moreno, Liseth Rivero Sánchez, Teresa Ocaña, Sabela Carballal, Antoni Castells, María Pellisé Urquiza, Francesc Balaguer, and Leticia Moreira Ruiz
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Hepatology ,Gastroenterology - Published
- 2023
5. TASA DE DETECCIÓN DE ADENOMAS CON POLIETILENGLICOL/ASCORBATO VERSUS PICOSULFATO SÓDICO/CITRATO MAGNÉSICO EN CRIBADO DEL CÁNCER COLORRECTAL: ENSAYO CLÍNICO PARALELO ALEATORIZADO Y CONTROLADO (ESTUDIO LOWOL)
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Sonia Torres Riera, Anna Serradesanferm Fabregas, Àngels Pozo Fernández, Teresa Ocaña Bombardó, Mireia Díaz Centeno, Rebeca Moreira de Abreu, Isabel Torá Rocamora, Liseth Rivero Sánchez, Sabela Carballal Ramil, Oswaldo Ortiz Zúñiga, Maria Daca-álvarez, and Maria Pellisé Urquiza
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Hepatology ,Gastroenterology - Published
- 2023
6. INCIDENCIA, TASA DE DETECCIÓN DE ADENOMAS Y FACTORES DE RIESGO DE CRC SEGÚN EL GEN AFECTO EN EL SÍNDROME DE LYNCH
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Ariadna Sánchez, Joaquin Castillo, Victorine H. Roos, Núria Dueñas, Marta Pineda, Berta Caballol, Lorena Moreno, Sabela Carballal, Lorena Rodríguez-Alonso, Teresa Ramón y Cajal, Gemma Llort, Virginia Piñol, Adrià López Fernández, Inmaculada Salces, Maria Dolores Picó, Laura Rivas, Luis Bujanda, Marta Garzón, Angeles Pizarro, Eva Martínez de Castro, Maria Jesus López-Arias, Carmen Poves, Catalina Garau, Daniel Rodríguez- Alcalde, Maite Herraiz, Cristina Alvarez-Urrutia, Andrés Dacal, Marta Carrillo-Palau, Lucia Cid, Marta Ponce, Eva Barreiro-Alonso, Esteban Saperas, Elena Aguirre, Teresa Ocaña, Liseth Rivero- Sánchez, Xavier Bessa, Joaquin Cubiella, Rodrigo Jover, Francisco Rodríguez-Moranta, Judith Balmaña, Joan Brunet, Antoni Castells, Evelien Dekker, Gabriel Capella, Leticia Moreira, Maria Pellise, and Francesc Balaguer
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Hepatology ,Gastroenterology - Published
- 2023
7. Personalised surveillance for serrated polyposis syndrome
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Liseth Rivero, Manon C.W. Spaander, Francisco Rodríguez-Moranta, Maria Pellise, Niels van Lelyveld, Willemijn de Klaver, Joep E. G. IJspeert, Sabela Carballal, Barbara A. J. Bastiaansen, Evelien Dekker, Jan J. Koornstra, Monique E. van Leerdam, Xavier Bessa, Gerhard Jung, Tanya M. Bisseling, Arne Bleijenberg, Iris D. Nagetaal, Francesc Balaguer, Luis Bujanda, Yasmijn van Herwaarden, Graduate School, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, AGEM - Digestive immunity, APH - Quality of Care, and Gastroenterology & Hepatology
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Male ,HYPERPLASTIC POLYPOSIS ,medicine.medical_specialty ,COLONOSCOPY ,Colon ,Colorectal cancer ,Colonoscopy ,Medical Overuse ,Colonic polyps ,COLORECTAL-CANCER ,Cohort Studies ,All institutes and research themes of the Radboud University Medical Center ,Risk Factors ,Internal medicine ,Tumours of the digestive tract Radboud Institute for Molecular Life Sciences [Radboudumc 14] ,Prevalence ,medicine ,Clinical endpoint ,Humans ,Cumulative incidence ,Prospective Studies ,Polyposis ,Aged ,Netherlands ,RISK ,medicine.diagnostic_test ,business.industry ,Incidence ,Incidence (epidemiology) ,Gastroenterology ,Middle Aged ,medicine.disease ,Serrated polyposis ,Miscellaneous ,Increased risk ,Adenomatous Polyposis Coli ,Spain ,Population Surveillance ,Female ,Colorectal Neoplasms ,business ,Follow-Up Studies ,Cohort study - Abstract
Background and aimsSerrated polyposis syndrome (SPS) is associated with an increased risk of colorectal cancer (CRC). International guidelines recommend surveillance intervals of 1–2 years. However, yearly surveillance likely leads to overtreatment for many. We prospectively assessed a surveillance protocol aiming to safely reduce the burden of colonoscopies.MethodsBetween 2013 and 2018, we enrolled SPS patients from nine Dutch and Spanish hospitals. Patients were surveilled using a protocol appointing either a 1-year or 2-year interval after each surveillance colonoscopy, based on polyp burden. Primary endpoint was the 5-year cumulative incidence of CRC and advanced neoplasia (AN) during surveillance.ResultsWe followed 271 SPS patients for a median of 3.6 years. During surveillance, two patients developed CRC (cumulative 5-year incidence 1.3%[95% CI 0% to 3.2%]). The 5-year AN incidence was 44% (95% CI 37% to 52%), and was lower for patients with SPS type III (26%) than for patients diagnosed with type I (53%) or type I and III (59%, pConclusionRisk stratification substantially reduced colonoscopy burden while achieving CRC incidence similar to previous studies. AN incidence is considerable in SPS patients, but extension of surveillance intervals was not associated with increased AN in those identified as low-risk by the protocol. We identified SPS type III patients as low-risk group that might benefit from even less frequent surveillance.Trial registration numberThe study was registered on http://www.trialregister.nl; trial-ID NTR4609.
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- 2020
8. Quality of Colonoscopy Is Associated With Adenoma Detection and Postcolonoscopy Colorectal Cancer Prevention in Lynch Syndrome
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Daniel Rodríguez-Alcalde, Angeles Pizarro, Maria Pellise, Cristina Romero, Berta Caballol, Lorena Moreno, Esteban Saperas, Eva Martinez de Castro, Gemma Llort, Laura Rivas, Catalina Garau, Ariadna Sánchez, Elena Aguirre, Sabela Carballal, Virginia Piñol, Eva Barreiro-Alonso, Matilde Navarro, Lorena Rodríguez-Alonso, Marta Garzon, Xavier Bessa, Teresa Ocaña, Marta Ponce, Carmen Poves, Inmaculada Salces, Gerhard Jung, Cristina Alvarez-Urrutia, Maite Herraiz, Liseth Rivero-Sánchez, Evelien Dekker, Joan Brunet, Judith Balmaña, Maribel Gonzalez-Acosta, Francesc Balaguer, Blai Morales-Romero, Luis Bujanda, Leticia Moreira, Joaquín Cubiella, Teresa Ramón y Cajal, Marta Pineda, Miquel Serra-Burriel, Victorine H. Roos, María Dolores Picó, Andres Dacal, Antoni Castells, Lucía Cid, Maria Jesus López-Arias, Rodrigo Jover, Francisco Rodríguez-Moranta, Gabriel Capellá, Marta Carrillo-Palau, Barbara A. J. Bastiaansen, Adrià López-Fernández, Gastroenterology and Hepatology, Graduate School, APH - Methodology, APH - Personalized Medicine, CCA - Imaging and biomarkers, CCA - Cancer Treatment and Quality of Life, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
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Adenoma ,medicine.medical_specialty ,Colorectal cancer ,Colonoscopy ,HNPCC ,Chromoendoscopy ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Interquartile range ,Internal medicine ,medicine ,Humans ,Cumulative incidence ,Colonoscopy Quality ,Colorectal Neoplasms, HNPCC, Hereditary Non-Polyposis Colorectal Cancer, Lynch syndrome, colonoscopy quality, colonoscopy, hereditary colorectal cancer ,neoplasms ,Early Detection of Cancer ,Hereditary Colorectal Cancer ,Hepatology ,medicine.diagnostic_test ,business.industry ,Incidence ,Incidence (epidemiology) ,Gastroenterology ,Hereditary Nonpolyposis Colorectal Cancer ,Odds ratio ,colonoscopy quality, colonoscopy ,medicine.disease ,Colorectal Neoplasms, Hereditary Nonpolyposis ,Lynch syndrome ,digestive system diseases ,Hereditary Non-Polyposis Colorectal Cancer ,030220 oncology & carcinogenesis ,Lynch Syndrome ,030211 gastroenterology & hepatology ,business ,Colorectal Neoplasms - Abstract
BACKGROUND & AIMS: Colonoscopy reduces colorectal cancer (CRC) incidence and mortality in Lynch syndrome (LS) carriers. However, a high incidence of postcolonoscopy CRC (PCCRC) has been reported. Colonoscopy is highly dependent on endoscopist skill and is subject to quality variability. We aimed to evaluate the impact of key colonoscopy quality indicators on adenoma detection and prevention of PCCRC in LS. METHODS: We conducted a multicenter study focused on LS carriers without previous CRC undergoing colonoscopy surveillance (n = 893). Incident colorectal neoplasia during surveillance and quality indicators of all colonoscopies were analyzed. We performed an emulated target trial comparing the results from the first and second surveillance colonoscopies to assess the effect of colonoscopy quality indicators on adenoma detection and PCCRC incidence. Risk analyses were conducted using a multivariable logistic regression model. RESULTS: The 10-year cumulative incidence of adenoma and PCCRC was 60.6% (95% CI, 55.5%-65.2%) and 7.9% (95% CI, 5.2%-10.6%), respectively. Adequate bowel preparation (odds ratio [OR], 2.07; 95% CI, 1.06-4.3), complete colonoscopies (20% vs 0%; P = .01), and panchromoendoscopy use (OR, 2.14; 95% CI, 1.15-3.95) were associated with significant improvement in adenoma detection. PCCRC risk was significantly lower when colonoscopies were performed during a time interval of less than every 3 years (OR, 0.35; 95% CI, 0.14-0.97). We observed a consistent but not significant reduction in PCCRC risk for a previous complete examination (OR, 0.16; 95% CI, 0.03-1.28), adequate bowel preparation (OR, 0.64; 95% CI, 0.17-3.24), or previous use of high-definition colonoscopy (OR, 0.37; 95% CI, 0.02-2.33). CONCLUSIONS: Complete colonoscopies with adequate bowel preparation and chromoendoscopy use are associated with improved adenoma detection, while surveillance intervals of less than 3 years are associated with a reduction of PCCRC incidence. In LS, high-quality colonoscopy surveillance is of utmost importance for CRC prevention.
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- 2022
9. Differentially Deregulated MicroRNAs as Novel Biomarkers for Neoplastic Progression in Ulcerative Colitis
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Isabel Quintanilla, Gerhard Jung, Mireya Jimeno, Juan José Lozano, Julia Sidorova, Jordi Camps, Sabela Carballal, Luis Bujanda, Maria Isabel Vera, Enrique Quintero, Marta Carrillo-Palau, Miriam Cuatrecasas, Antoni Castells, Julià Panés, Elena Ricart, Leticia Moreira, Francesc Balaguer, and Maria Pellisé
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Adenoma ,MicroRNAs ,Gastroenterology ,Humans ,Colitis, Ulcerative ,Real-Time Polymerase Chain Reaction ,Biomarkers - Abstract
INTRODUCTION: Colorectal cancer (CRC) is a potentially life-threatening complication of long-standing ulcerative colitis (UC). MicroRNAs (miRNA) are epigenetic regulators that have been involved in the development of UC-associated CRC. However, their role as potential mucosal biomarkers of neoplastic progression has not been adequately studied. METHODS: In this study, we analyzed the expression of 96 preselected miRNAs in human formalin-fixed and paraffin-embedded tissue of 52 case biopsies (20 normal mucosa, 20 dysplasia, and 12 UC-associated CRCs) and 50 control biopsies (10 normal mucosa, 21 sporadic adenomas, and 19 sporadic CRCs) by using Custom TaqMan Array Cards. For validation of deregulated miRNAs, we performed individual quantitative real-time polymerase chain reaction in an independent cohort of 50 cases (13 normal mucosa, 25 dysplasia, and 12 UC-associated CRCs) and 46 controls (7 normal mucosa, 19 sporadic adenomas, and 20 sporadic CRCs). RESULTS: Sixty-four miRNAs were found to be differentially deregulated in the UC-associated CRC sequence. Eight of these miRNAs were chosen for further validation. We confirmed miR-31, -106a, and -135b to be significantly deregulated between normal mucosa and dysplasia, as well as across the UC-associated CRC sequence (all P < 0.01). Notably, these miRNAs also confirmed to have a significant differential expression compared with sporadic CRC (all P < 0.05). DISCUSSION: UC-associated and sporadic CRCs have distinct miRNA expression patterns, and some miRNAs indicate early neoplastic progression. This work was funded by grants from the Instituto de Salud Carlos III (PI12/01481; PI19/01050). Project PI19/ 01050 is funded by Instituto de Salud Carlos III (ISCIII) and co funded by the European Union. CIBEREHD is funded by the Insti tuto de Salud Carlos III and Beca Marató de TV3 (201932-30). Parts of this work were also supported by the Xarxa de Bancs de Tumors de Catalunya sponsored by Pla Director d’Oncología de Catalunya (XBTC) and by the Hospital Clínics Premi Fi de Residència (G.J). None of the funding parties has been involved in collection, analysis, and interpretation of the data.
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- 2021
10. Clinical, Molecular and Genetic Characteristics of Early Onset Gastric Cancer: Analysis of a Large Multicenter Study
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Ariadna Sánchez, Miriam Cuatrecasas, Sabela Carballal, Anna Pocurull, Josep M. Botargues, Cristina Herrera-Pariente, Joan Llach, Laura Carot, Teresa Ocaña, Leticia Moreira, Francesc Balaguer, and Luis Bujanda
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Cancer Research ,medicine.medical_specialty ,Stomach cancer ,Genetic counseling ,DNA mismatch repair ,MLH1 ,Gastroenterology ,familial cancer ,Article ,03 medical and health sciences ,0302 clinical medicine ,Germline mutation ,Internal medicine ,PMS2 ,Malalties hereditàries ,Medicine ,Family history ,RC254-282 ,Genetic heterogeneity ,business.industry ,gastric cancer ,Càncer d'estómac ,Family aggregation ,Cancer ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,early onset cancer ,Oncology ,hereditary cancer ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business ,Genetic disorders - Abstract
Simple Summary Gastric cancer is one of the most common cancers worldwide, showing high mortality rates. A small portion of gastric cancer patients, known as early onset gastric cancer (EOGC) patients, develop the disease before age 50, and their characteristics are poorly described. Thus, our main objective was to describe the clinical, molecular, and genetic characteristics of EOGC in a large multicenter cohort of patients. We were able to identify that most EOGC cases have similar characteristics: diagnosed at advanced stage, diffuse type, and infrequent DNA mismatch repair somatic deficiency. Although familial aggregation of gastric cancer was uncommon, a germline genetic mutation was identified in 25% of the patients tested. Our results show that EOGC has a marked genetic heterogeneity. Thus, it is essential to consider familial history of tumors, not only GC, in order to select adequate patients to perform a suitable genetic counseling and enhance the emerging use of multigene panels. Abstract Gastric adenocarcinoma (GC) is a common tumor with high morbidity and mortality. Only 7% of patients with GC are diagnosed before age 50 (early onset gastric cancer (EOGC)), and their characteristics have been poorly described. We aimed to describe clinical, molecular, and genetic characteristics of EOGC. A total of 309 patients with EOGC were retrospectively studied in four Spanish centers. Personal information, family history, and tumor information were registered. Germinal genetic analysis was performed in patients who met current criteria of a hereditary syndrome at the time of diagnosis. The median age at diagnosis was 44 years. The majority (73.3%) of tumors were diffuse, and 78.3% were diagnosed in an advanced stage. Familial aggregation of GC was present in 18/117 (15.4%) cases, and 5/117 (4.3%) met criteria for familial GC. MMR-IHC was performed in 126/309 (40.7%) tumors: 4/126 (3.1%) had loss of expression in MLH1/PMS2, without an associated germline mutation. Sixteen germline genetic analyses were performed, detecting a pathogenic variant in four (25%) cases: one in BRCA2, one in TP53, and two in CDH1. Most EOGC are diffuse and diagnosed in an advanced stage. In these patients, DNA MMR system deficiency is uncommon. Although familial aggregation was observed in only 15% of cases, a germline mutation was found in 25% of patients tested with clinical criteria. This demonstrates that EOGC has a marked genetic heterogeneity, reinforcing the importance of an accurate genetic counseling and enhancing the emerging use of multigene panels.
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- 2021
11. Endocuff-assisted colonoscopy for surveillance of serrated polyposis syndrome: a multicenter randomized controlled trial
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Ariadna Sánchez, Coral Arnau-Collell, Cristina Rodríguez de Miguel, Josep Llach, Jorge López Vicente, Ignasi Puig, Mireia Díaz, Oswaldo Ortiz, Leticia Moreira, Liseth Rivero-Sánchez, Francesc Balaguer, Luis Hernandez Villalba, Sabela Carballal, Teresa Ocaña, Miriam Cuatrecasas, Lorena Moreno, and Maria Pellise
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Male ,medicine.medical_specialty ,Adenoma ,Colorectal cancer ,Population ,Colonoscopy ,Withdrawal time ,Gastroenterology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Humans ,education ,Early Detection of Cancer ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Equipment Design ,Middle Aged ,medicine.disease ,Serrated polyposis ,Confidence interval ,Adenomatous Polyposis Coli ,030220 oncology & carcinogenesis ,Colonic Neoplasms ,Female ,030211 gastroenterology & hepatology ,business - Abstract
Background and study aims Serrated polyposis syndrome (SPS) is a condition with high risk for colorectal cancer. The Endocuff device has been shown to increase adenoma detection in the general and screening population. We aimed to ascertain whether Endocuff-assisted colonoscopy increases detection of serrated lesions in comparison with standard colonoscopy during the surveillance of patients with SPS. Methods In a multicenter randomized controlled study, patients who met SPS criteria I and/or III under surveillance (previous resection of all serrated lesions ≥ 4 mm) were consecutively randomly allocated 1:1 to Endocuff-assisted colonoscopy or standard colonoscopy, performed by expert endoscopists. The main outcome was the mean number of serrated lesions detected per patient. Results 122 patients (standard colonoscopy n = 60; Endocuff-assisted colonoscopy n = 62; 59 % men; mean age 60.6 (standard deviation [SD] 7.5) were included at 4 centers. Baseline variables (demographic data, SPS phenotype, colorectal cancer [CRC] history, cumulative polyps, and follow-up), cecal intubation rate, and withdrawal time were similar between groups. There was no statistically significant difference between Endocuff-assisted colonoscopy and standard colonoscopy for the mean number of serrated lesions detected per patient: 5.8 (95 % confidence interval [95 %CI] 4.4 – 7.2) and 5.0 (3.9 – 6.1), respectively (P = 0.36). There were also no differences between Endocuff-assisted and standard colonoscopy for detection of sessile serrated lesions (mean number per patient 2.5 [1.3 – 3.6] vs. 2.0 [1.1 – 3.0], P = 0.54) and adenomas (0.9 [0.5 – 1.3] vs. 0.5 [0.3 – 0.7], P = 0.12). Conclusion Use of Endocuff-assisted colonoscopy did not significantly increase the number of serrated lesion detected per patient during surveillance of SPS.
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- 2019
12. Guía de práctica clínica. Diagnóstico y prevención del cáncer colorrectal. Actualización 2018
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Maria Pellise, Rodrigo Jover, Joaquín Cubiella, Enrique Quintero, Pablo Vega-Villaamil, Francisco Javier Amador-Romero, Juan Ferrándiz-Santos, Elena Rodríguez-Camacho, Begoña Bellas-Beceiro, Leticia Moreira, Juan José Mascort-Roca, Carolina Mangas-Sanjuan, Sabela Carballal, Joan Clofent-Vilaplana, Antonio Z. Gimeno-García, and Mercè Marzo-Castillejo
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03 medical and health sciences ,0302 clinical medicine ,Hepatology ,business.industry ,030220 oncology & carcinogenesis ,Gastroenterology ,Medicine ,030211 gastroenterology & hepatology ,business ,Humanities - Abstract
Resumen Este documento actualiza las recomendaciones realizadas por la Sociedad Espanola de Medicina Familiar y Comunitaria y la Asociacion Espanola de Gastroenterologia para el diagnostico y la prevencion del cancer colorrectal (CCR). Para establecer la calidad de la evidencia y los niveles de recomendacion de las intervenciones se ha utilizado la metodologia basada en el sistema GRADE (Grading of Recommendations Assessment, Development and Evaluation). Este documento establece intervalos de demora optimos en funcion de los sintomas y el test de SOH inmunologico (SOHi) y recomienda reducir las barreras para la confirmacion diagnostica en los pacientes con sintomas. En cuanto al cribado en poblacion de riesgo medio, se proponen estrategias para conseguir la implantacion universal del cribado poblacional basado en SOHi bienal e incrementar la participacion de la poblacion diana, incluyendo la implicacion de atencion primaria. Esta guia de practica clinica recomienda el cribado universal del sindrome de Lynch mediante la inmunohistoquimica de las proteinas reparadoras o la inestabilidad de microsatelites en los CCR incidentes y el uso de paneles de genes en los pacientes con poliposis adenomatosas. Tambien actualiza las estrategias para reducir la incidencia y la mortalidad tanto de CCR como de otros tumores asociados a los sindromes hereditarios. En cuanto al CCR familiar no hereditario y la vigilancia tras reseccion de CCR, adenomas y lesiones serradas, se establecen recomendaciones en funcion del riesgo atribuible y la reduccion del riesgo de la intervencion propuesta. Finalmente, en el documento se incluyen recomendaciones respecto a los intervalos de vigilancia en la enfermedad inflamatoria intestinal y la actitud ante la displasia.
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- 2018
13. Update on the World Health Organization Criteria for Diagnosis of Serrated Polyposis Syndrome
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Evelien Dekker, Arne Bleijenberg, Francesc Balaguer, Joep E.G. IJspeert, Arne G.C. Bleijenberg, Maria Pellisé, Sabela Carballal, Liseth Rivero, A. Latchford, Gastroenterology and Hepatology, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, Graduate School, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, and APH - Quality of Care
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medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Colonic Polyps ,Colonoscopy ,World Health Organization ,Serrated polyposis ,World health ,Neoplastic Syndromes, Hereditary ,Family medicine ,Practice Guidelines as Topic ,medicine ,Humans ,business ,Colorectal Neoplasms ,Watchful Waiting - Published
- 2019
14. White-Light Endoscopy Is Adequate for Lynch Syndrome Surveillance in a Randomized and Noninferiority Study
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María López-Cerón, Antonio Z. Gimeno-García, Ariadna Sánchez, Sofía Parejo, Victoria Alvarez, Liseth Rivero-Sánchez, Beatriz Peñas, David Remedios, Joaquín Cubiella, Cristina Rodríguez de Miguel, Gerhard Jung, Patricia Calvo, Cristina Carretero, Alain Huerta, Maite Herraiz, Teresa Ocaña, Jorge López-Vicente, Leticia Moreira, Jordi Gordillo, Esteban Saperas, Maria Pellise, Antoni Castells, Rebeca Moreira, Cristina Alvarez-Urturi, Jesús Herrero, Sabela Carballal, Eduardo Albéniz, Josep Llach, Francesc Balaguer, Inmaculada Salces, Ignasi Puig, Marta García-Cougil, Coral Arnau-Collell, and Enrique Rodríguez de Santiago
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0301 basic medicine ,Adenoma ,Adult ,Male ,medicine.medical_specialty ,ADR ,Colorectal cancer ,Colonoscopy ,Gastroenterology ,Chromoendoscopy ,03 medical and health sciences ,Polyp ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Panchromoendoscopy ,Prospective Studies ,Prospective cohort study ,Early Detection of Cancer ,Hepatology ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Colorectal Neoplasms, Hereditary Nonpolyposis ,Confidence interval ,Lynch syndrome ,CRC ,Endoscopy ,030104 developmental biology ,Population Surveillance ,030211 gastroenterology & hepatology ,Female ,business ,Colorectal Neoplasms - Abstract
Background & Aims Dye-based pancolonic chromoendoscopy is recommended for colorectal cancer surveillance in patients with Lynch syndrome. However, there is scarce evidence to support its superiority to high-definition white-light endoscopy. We performed a prospective study assess whether in the hands of high detecting colonoscopists, high-definition, white-light endoscopy is noninferior to pancolonic chromoendoscopy for detection of adenomas in patients with Lynch syndrome. Methods We conducted a parallel controlled study, from July 2016 through January 2018 at 14 centers in Spain of adults with pathogenic germline variants in mismatch repair genes (60% women; mean age, 47 ± 14 years) under surveillance. Patients were randomly assigned to groups that underwent high-definition white-light endoscopy (n = 128) or pancolonic chromoendoscopy (n = 128) evaluations by 24 colonoscopists who specialized in detection of colorectal lesions in high-risk patients for colorectal cancer. Adenoma detection rates (defined as the proportion of patients with at least 1 adenoma) were compared between groups, with a noninferiority margin (relative difference) of 15%. Results We found an important overlap of confidence intervals (CIs) and no significant difference in adenoma detection rates by pancolonic chromoendoscopy (34.4%; 95% CI 26.4%–43.3%) vs white-light endoscopy (28.1%; 95% CI 21.1%–36.4%; P = .28). However, pancolonic chromoendoscopy detected serrated lesions in a significantly higher proportion of patients (37.5%; 95% CI 29.5–46.1) than white-light endoscopy (23.4%; 95% CI 16.9–31.4; P = .01). However, there were no significant differences between groups in proportions of patients found to have serrated lesions of 5 mm or larger (9.4% vs 7.0%; P = .49), of proximal location (11.7% vs 10.2%; P = .68), or sessile serrated lesions (3.9% vs 5.5%; P = .55), respectively. Total procedure and withdrawal times with pancolonic chromoendoscopy (30.7 ± 12.8 minutes and 18.3 ± 7.6 minutes, respectively) were significantly longer than with white-light endoscopy (22.4 ± 8.7 minutes and 13.5 ± 5.6 minutes; P Conclusions In a randomized parallel trial, we found that for Lynch syndrome surveillance, high-definition white-light endoscopy is not inferior to pancolonic chromoendoscopy if performed by experienced and dedicated endoscopists. ClinicalTrials.gov no: NCT02951390.
- Published
- 2019
15. Low Incidence of Advanced Neoplasia in Serrated Polyposis Syndrome After (Sub)total Colectomy: Results of a 5-Year International Prospective Cohort Study
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Daniel Rodríguez-Alcalde, Xavier Bessa, Arne Bleijenberg, Gerhard Jung, Tanya M. Bisseling, Barbara A. J. Bastiaansen, Evelien Dekker, Liseth Rivero, Francesc Balaguer, Francisco Rodríguez-Moranta, M E van Leerdam, Sabela Carballal, W. A. Bemelman, Y J van Herwaarden, Luis Bujanda, N. van Lelyveld, Iris D. Nagtegaal, W. de Klaver, Maria Pellise, Joep E. G. IJspeert, M C W Spaander, Jan J. Koornstra, Gastroenterology & Hepatology, Gastroenterology and Hepatology, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, Surgery, and APH - Quality of Care
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Male ,medicine.medical_specialty ,COLONOSCOPY ,Colonoscopy ,Colonic Polyps ,Anastomosis ,COLORECTAL-CANCER ,Cohort Studies ,Neoplasms, Multiple Primary ,03 medical and health sciences ,Adenomatous Polyps ,0302 clinical medicine ,Interquartile range ,Internal medicine ,medicine ,Tumours of the digestive tract Radboud Institute for Molecular Life Sciences [Radboudumc 14] ,Humans ,Prospective Studies ,Prospective cohort study ,Colectomy ,Aged ,LESIONS ,Hepatology ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Carcinoma ,Gastroenterology ,Absolute risk reduction ,Middle Aged ,Confidence interval ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,Neoplasm Recurrence, Local ,business ,Colorectal Neoplasms ,Cohort study - Abstract
Contains fulltext : 208519pub.pdf (Publisher’s version ) (Closed access) INTRODUCTION: Serrated polyposis syndrome (SPS) is accompanied by a substantially increased colorectal cancer (CRC) risk. To prevent or treat CRC in patients with a very high polyp burden, (sub)total colectomy with ileorectal or ileosigmoidal anastomosis is regularly performed. The CRC risk after (sub)total colectomy might be decreased, but evidence is lacking. We aimed to assess the yield of endoscopic surveillance in patients with SPS who underwent (sub)total colectomy. METHODS: For this post hoc analysis, we used prospectively collected data from a large international prospective cohort study. We included patients diagnosed with SPS (World Health Organization type I and/or III) who underwent (sub)total colectomy. Primary endpoint was the cumulative 5-year incidence of CRC and advanced neoplasia (AN). RESULTS: Forty-eight patients (mean age 61 [+/-7.8]; 52% men) were included and followed up for a median of 4.7 years (interquartile range 4.7-5.1). None of the patients developed CRC during follow-up. Five patients developed AN, corresponding to a cumulative 5-year AN incidence of 13% (95% confidence interval 1.2-23). In 4 patients, AN was diagnosed at the first surveillance endoscopy after study inclusion, and in 1 patient, AN was detected during subsequent rounds of surveillance. The risk of AN was similar for patients with ileorectal and ileosigmoidal anastomosis (logrank P = 0.83). DISCUSSION: (Sub)total colectomy mitigates much of the excess risk of CRC in patients with SPS. Advanced neoplasms are mainly detected at the first endoscopy after (sub)total colectomy. Based on these results, after the first surveillance, intervals might be extended beyond the currently recommended 1-2 years.
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- 2019
16. Identification of a Novel Candidate Gene for Serrated Polyposis Syndrome Germline Predisposition by Performing Linkage Analysis Combined With Whole-Exome Sequencing
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Aránzazu Díaz de Bustamante, Laia Bonjoch, Joaquín Cubiella, Coral Arnau-Collell, Antoni Castells, Sergi Castellví-Bel, Sebastià Franch-Expósito, Sabela Carballal, Francesc Balaguer, Yasmin Soares de Lima, Marcos Díaz-Gay, Luis Bujanda, Daniel Rodríguez-Alcalde, Teresa Ocaña, Janice M. Fullerton, Miriam Cuatrecasas, Jenifer Muñoz, Claudio Toma, and Bronwyn Overs
- Subjects
Adult ,Male ,Candidate gene ,Genetic Linkage ,Colon ,Colorectal cancer ,Genetic counseling ,education ,Genetic Counseling ,Locus (genetics) ,Polymorphism, Single Nucleotide ,Article ,Germline ,Young Adult ,03 medical and health sciences ,fluids and secretions ,0302 clinical medicine ,Genetic linkage ,Exome Sequencing ,Biomarkers, Tumor ,medicine ,Humans ,Genetic Predisposition to Disease ,Exome sequencing ,Aged ,Genetics ,Extracellular Matrix Proteins ,locus ,business.industry ,pathway ,Calcium-Binding Proteins ,fungi ,Gastroenterology ,colorectal-cancer ,rare variants ,Middle Aged ,families ,equipment and supplies ,medicine.disease ,Serrated polyposis ,3. Good health ,Adenomatous Polyposis Coli ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,rnf43 mutations ,business - Abstract
SUPPLEMENTARY MATERIAL accompanies this paper athttp://links.lww.com/CTG/A114 OBJECTIVES: Serrated polyposis syndrome (SPS) is a complex disorder with a high risk of colorectal cancer for which the germline factors remain largely unknown. Here, we combined whole-exome sequencing (WES) and linkage studies in families with multiple members affected by SPS to identify candidate genes harboring rare variants with higher penetrance effects. METHODS: Thirty-nine affected subjects from 16 extended SPS families underwent WES. Genome-wide linkage analysis was performed under linear and exponential models. The contribution of rare coding variants selected to be highly pathogenic was assessed using the gene-based segregation test. RESULTS: significant linkage peak was identified on chromosome 3p25.2-p22.3 (maxSNP = rs2293787; LODlinear = 2.311, LODexp = 2.11), which logarithm of the odds (LOD) score increased after fine mapping for the same marker (maxSNP = rs2293787; LODlinear = 2.4, LODexp = 2.25). This linkage signal was replicated in 10 independent sets of random markers from this locus. To assess the contribution of rare variants predicted to be pathogenic, we performed a family-based segregation test with 11 rare variants predicted to be deleterious from 10 genes under the linkage intervals. This analysis showed significant segregation of rare variants with SPS in CAPT7, TMEM43, NGLY1, and FBLN2 genes (weighted Pvalue > 0.007). DISCUSSION: Protein network analysis suggested FBLN2 as the most plausible candidate genes for germline SPS predisposition. Etiologic rare variants implicated in disease predisposition may be identified by combining traditional linkage with WES data. This powerful approach was effective for the identification of a new candidate gene for hereditary SPS. M.D.-G. was supported by a contract from Agencia de Gestio d'Ajuts Universitaris i de Recerca (AGAUR) (Generalitat de Catalunya, 2018FI_B1_00213). S.F.-E., C.A.-C. and J.M. were supported by a contract from CIBEREHD. Y.S.L. was supported by a fellowship (LCF/BQ/DI18/11660058) from "la Caixa" Foundation (ID 100010434) funded EU Horizon 2020 Programme (Marie Sklodowska-Curie grant agreement no. 713673). LB was supported by a Juan de la Cierva postdoctoral contract (FJCI-2017-32593). CIBEREHD and CIBERONC are funded by the Instituto de Salud Carlos III. CT, BJO, and JMF were supported by Australian National Health and Medical Research (NHMRC) Project Grants 1063960 and 1066177. This research was supported by grants from Fondo de Investigacion Sanitaria/FEDER (16/00766, 17/00878), Fundacion Cientifica de la Asociacion Espanola contra el Cancer (GCB13131592CAST), PERIS (SLT002/16/00398, Generalitat de Catalunya), CERCA Programme (Generalitat de Catalunya), and Agencia de Gestio d'Ajuts Universitaris i de Recerca (Generalitat de Catalunya, GRPRE 2017SGR21, GRC 2017SGR653). This article is based on work from COST Action CA17118, supported by COST (European Cooperation in Science and Technology). www.cost.eu.Potential competing interests: None to report.
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- 2019
17. Reassessment colonoscopy to diagnose serrated polyposis syndrome in a colorectal cancer screening population
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Anna Serradesanferm, Antoni Castells, Xavier Bessa, Maria Liz Leoz, Maria Pellise, Sabela Carballal, Ariadna Sánchez, Francesc Balaguer, Josep M. Augé, Teresa Ocaña, Angels Pozo, Josep Llach, María López-Cerón, Jaume Grau, Liseth Rivero-Sánchez, Leticia Moreira, and Miriam Cuatrecasas
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Male ,medicine.medical_specialty ,Colorectal cancer ,Population ,Colonic Polyps ,Colonoscopy ,Gastroenterology ,Chromoendoscopy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,education ,Prospective cohort study ,Early Detection of Cancer ,Retrospective Studies ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,Syndrome ,Odds ratio ,Middle Aged ,medicine.disease ,Endoscopy ,Occult Blood ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Radiology ,business ,Precancerous Conditions - Abstract
Background and study aims Serrated polyposis syndrome (SPS) is a high risk condition for colorectal cancer (CRC). Surveillance strategies for patients with serrated lesions remain controversial. We aimed to evaluate a diagnostic strategy to detect SPS consistently during reassessment colonoscopy in patients with proximal serrated lesions. Methods This was a retrospective study of all individuals from a fecal immunochemical test (FIT)-based CRC screening program (2010 – 2013) with one or more serrated lesions of ≥ 5 mm proximal to the sigmoid colon on baseline colonoscopy. We analyzed all individuals empirically scheduled for a reassessment colonoscopy aimed at diagnosing SPS within 1 year. Reassessment colonoscopy was performed with standard white-light or chromoendoscopy ± high definition endoscopy depending on availability. SPS diagnosis was based on the cumulative number of polyps in both the baseline and reassessment colonoscopies. Factors associated with SPS diagnosis were analyzed. Results From 3444 screening colonoscopies, 196 patients met the study entry criteria, of whom 11 patients (0.32 %) met the criteria for SPS on baseline colonoscopy. Reassessment colonoscopies were performed in 71 patients at 11.9 ± 1.7 months and detected 20 additional patients with SPS, a tripling of the rate of SPS up to 0.90 %. Independent factors associated with SPS diagnosis were: having five or more proximal serrated lesions (odds ratio [OR] 4.01 [95 % confidence interval 1.20 – 13.45]; P = 0.02) or two or more sessile serrated polyps ≥ 10 mm (OR 6.35 [1.40 – 28.81]; P = 0.02) on baseline colonoscopy and the use of chromoendoscopy ± high definition endoscopy during reassessment colonoscopy (OR 4.99 [1.11 – 22.36]; P = 0.04). Conclusions A 1-year reassessment colonoscopy using chromoendoscopy and high definition endoscopes substantially improves SPS detection in individuals from a FIT-based screening program with proximal serrated lesions. Five or more proximal serrated lesions or two or more sessile serrated polyps ≥ 10 mm could be thresholds for requiring a reassessment colonoscopy. Prospective studies are required to validate these results and adjust surveillance recommendations in patients with serrated lesions.
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- 2016
18. Novedades en la vigilancia de pólipos colorrectales
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Sabela Carballal
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medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,Adenoma ,Colorectal cancer ,business.industry ,Serrated polyp ,Gastroenterology ,Colonoscopy ,medicine.disease ,digestive system diseases ,Clinical Practice ,Internal medicine ,medicine ,business - Abstract
Colorectal adenomas and serrated polyps are the best characterised premalignant lesions involved in the development of colorectal cancer (CRC). Therefore, the identification and removal of these lesions, as well as post-polypectomy surveillance of affected patients, are key goals in the field of CRC prevention. Current post-polypectomy surveillance strategies differ among the various scientific societies and have several limitations that hamper their application in clinical practice. First, current surveillance intervals are based only on polyp characteristics, excluding other potential clinical conditions, such as diabetes or metabolic syndrome. Second, serrated polyps and adenomas are considered separately, but there is no recommendation in cases of the simultaneous occurrence of both types of lesion. Third, the incorporation of endoscopic technologies implies an increase in polyp detection, whose clinical impact is controversial and directly affects the number of scheduled colonoscopies with an indication of surveillance. Some of the studies presented at the AGA (American Gastroenterological Association) meeting aimed to provide new evidence on the follow-up of colorectal polyps, with a view to optimising the applicability and suitability of current surveillance strategies.
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- 2016
19. Síndromes de predisposición a cáncer gástrico y cáncer pancreático
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Maria Liz Leoz, Francesc Balaguer, Leticia Moreira, Ariadna Sánchez, Maria Pellise, Sabela Carballal, Teresa Ocaña, Antoni Castells, and Lucía Ruano
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medicine.medical_specialty ,Hepatology ,business.industry ,Colorectal cancer ,Mortality rate ,Gastroenterology ,medicine.disease ,Lynch syndrome ,Familial adenomatous polyposis ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,030211 gastroenterology & hepatology ,business - Abstract
The most common hereditary gastrointestinal cancers are colorectal, mainly hereditary nonpolyposis colorectal cancer (Lynch syndrome) and familial adenomatous polyposis. Other extracolonic neoplasms, including the gastric and pancreatic adenocarcinomas, are less well known and studied because they account for a relatively small percentage of hereditary gastrointestinal cancers. Nonetheless, they merit special attention because of the high associated morbidity and mortality rates. We review the hereditary and familial syndromes associated with gastric and pancreatic cancers with a view to improving knowledge and understanding of these diseases, in order to heighten diagnostic suspicion and thus implement appropriate diagnostic strategies, screening, surveillance and treatment.
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- 2016
20. Hereditary gastric and pancreatic cancer predisposition syndromes
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Ariadna Sánchez, Leticia Moreira, Maria Pellise, Maria Liz Leoz, Antoni Castells, Francesc Balaguer, Sabela Carballal, Lucía Ruano, and Teresa Ocaña
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Male ,Risk ,Oncology ,medicine.medical_specialty ,Cystic Fibrosis ,Colorectal cancer ,Breast Neoplasms ,Adenocarcinoma ,Gastroenterology ,Familial adenomatous polyposis ,Neoplasms, Multiple Primary ,03 medical and health sciences ,0302 clinical medicine ,Neoplastic Syndromes, Hereditary ,Stomach Neoplasms ,Pancreatic cancer ,Internal medicine ,medicine ,Humans ,Genes, Tumor Suppressor ,Genetic Predisposition to Disease ,Endoscopy, Digestive System ,Melanoma ,Early Detection of Cancer ,Hereditary Pancreatic Cancer ,Ovarian Neoplasms ,business.industry ,Mortality rate ,Cancer ,medicine.disease ,Lynch syndrome ,Pancreatic Neoplasms ,030220 oncology & carcinogenesis ,Mutation ,Female ,030211 gastroenterology & hepatology ,Familial Cancer ,Colorectal Neoplasms ,business ,Forecasting ,Genes, Neoplasm - Abstract
The most common hereditary gastrointestinal cancers are colorectal, mainly hereditary nonpolyposis colorectal cancer (Lynch syndrome) and familial adenomatous polyposis. Other extracolonic neoplasms, including the gastric and pancreatic adenocarcinomas, are less well known and studied because they account for a relatively small percentage of hereditary gastrointestinal cancers. Nonetheless, they merit special attention because of the high associated morbidity and mortality rates. We review the hereditary and familial syndromes associated with gastric and pancreatic cancers with a view to improving knowledge and understanding of these diseases, in order to heighten diagnostic suspicion and thus implement appropriate diagnostic strategies, screening, surveillance and treatment.
- Published
- 2016
21. Mo1661 HISINVIA: A HYBRID SOLUTION FOR COLONIC POLYP HISTOLOGY PREDICTION IN WHITE LIGHT COLONOSCOPY IMAGES COMBINING ARTIFICIAL INTELLIGENCE AND CLINICAL INFORMATION
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Miriam Cuatrecasas, Maria Pellise, Liseth Rivero, Rodrigo Garcés-Durán, Ana García-Rodríguez, Jorge Bernal, Yael Tudela, Francisco Javier Sánchez, Josep Llach, Sabela Carballal, Henry Córdova, Leticia Moreira, and Gloria Fernández-Esparrach
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Colonoscopy ,Histology ,Colonic Polyp ,Clinical information ,medicine ,White light ,Hybrid solution ,Radiology, Nuclear Medicine and imaging ,Radiology ,business - Published
- 2020
22. 598 POST-COLONOSCOPY COLORECTAL CANCER IN LYNCH SYNDROME IS ASSOCIATED WITH QUALITY ISSUES DURING SURVEILLANCE
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Adolfo Suárez, Esteban Saperas, Daniel Rodríguez-Alcalde, Ariadna Sanchez Garcia, Lorena Moreno, Joan Brunet, Miquel Serra, Elena Aguirre, Marta Ponce, Teresa Ocaña, Marta Carrillo-Palau, Antoni Castells, Andres Dacal, Laura Rivas, Catalina Garau, Virginia Piñol, Berta Caballol, Liseth Rivero, M. J. López-Arias, Teresa Ramón y Cajal, Eva Martínez de Castro, Carmen Poves, Lorena Rodríguez-Alonso, Inmaculada Salces, Francisco Rodríguez-Moranta, Cristina de la Peña Álvarez, Lucía Cid, Maite Herraiz, Gemma Llort, Francesc Balaguer, Evelien Dekker, Gabriel Capellá, Victorine H. Roos, Adrià Lopez Fernandez, Luis Bujanda, María Dolores Picó, Marta Garzon, Leticia Moreira, Matilde Navarro, Xavier Bessa, Maria Pellise, Rodrigo Jover, J. Balmaña, Angeles Pizarro, Sabela Carballal, Joaquín Cubiella, and Marta Pineda
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medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,business.industry ,Colorectal cancer ,media_common.quotation_subject ,General surgery ,Gastroenterology ,Colonoscopy ,medicine.disease ,Lynch syndrome ,Medicine ,Quality (business) ,business ,media_common - Published
- 2020
23. High incidence of advanced colorectal neoplasia during endoscopic surveillance in serrated polyposis syndrome
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Lucía Cid, Xavier Bessa, Gerhard Jung, Susana Oquiñena, Mariano González, Maria Vila-Casadesús, Ariadna Sánchez, Joan Clofent, Luis Hernández, Victoria Gonzalo, Sabela Carballal, Miriam Cuatrecasas, Lorena Rodríguez-Alonso, Virginia Piñol, Joaquín Cubiella, Leticia Moreira, Enrique Quintero, F. Fernandez, Maria Pellise, Daniel Rodríguez-Alcalde, Carmen Poves, María López-Cerón, Jorge López-Vicente, Esteve Saperas, Pilar Esteban, Inés Castro, Francesc Balaguer, Luis Bujanda, Liseth Rivero-Sánchez, Eloisa Moya, Francisco Rodríguez-Moranta, Rodrigo Jover, and Antoni Castells
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Male ,medicine.medical_specialty ,Colorectal cancer ,Colonoscopy ,Rectum ,Risk Factors ,Internal medicine ,medicine ,Humans ,Cumulative incidence ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Incidence ,Gastroenterology ,Retrospective cohort study ,Odds ratio ,Syndrome ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Adenomatous Polyposis Coli ,Dysplasia ,Spain ,Female ,business ,Colorectal Neoplasms - Abstract
Background Serrated polyposis syndrome (SPS) has been associated with an increased risk of colorectal cancer (CRC). Accordingly, intensive surveillance with annual colonoscopy is advised. The aim of this multicenter study was to describe the risk of advanced lesions in SPS patients undergoing surveillance, and to identify risk factors that could guide the prevention strategy. Methods From March 2013 to April 2015, 296 patients who fulfilled criteria I and/or III for SPS were retrospectively recruited at 18 centers. We selected patients in whom successful clearing colonoscopy had been performed and who underwent subsequent endoscopic surveillance. Advanced neoplasia was defined as CRC, advanced adenoma, or advanced serrated lesion that were ≥ 10 mm and/or with dysplasia. Cumulative incidence of advanced neoplasia was calculated and independent predictors of advanced neoplasia development were identified. Results In 152 SPS patients a total of 315 surveillance colonoscopies were performed (median 2, range 1 – 7). The 3-year cumulative incidence of CRC and advanced neoplasia were 3.1 % (95 % confidence interval [CI] 0 – 6.9) and 42.0 % (95 %CI 32.4 – 51.7), respectively. Fulfilling both I + III criteria and the presence of advanced serrated lesions at baseline colonoscopy were independent predictors of advanced neoplasia development (odds ratio [OR] 1.85, 95 %CI 1.03 – 3.33, P = 0.04 and OR 2.62, 95 %CI 1.18 – 5.81, P = 0.02, respectively). During follow-up, nine patients (5.9 %) were referred for surgery for invasive CRC (n = 4, 2.6 %) or because of polyp burden (n = 5, 3.3 %). After total colectomy, 17.9 % patients developed advanced neoplasia in the retained rectum. Conclusions Patients with SPS have a substantial risk of developing advanced neoplasia under endoscopic surveillance, whereas CRC incidence is low. Personalized endoscopic surveillance based on polyp burden and advanced serrated histology could help to optimize prevention in patients with SPS.
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- 2018
24. Real-life chromoendoscopy for neoplasia detection and characterisation in long-standing IBD
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María López-Cerón, Ignasi Puig, Jordi Gordillo, Lucía Márquez, Pablo Vega, Beatriz Peñas, Elena Ricart, José Carlos Marín-Garbriel, Marco Antonio Álvarez, Mireya Jimeno, Antonio López-Serrano, Maria Pellise, Sabela Carballal, María Isabel Vera, Miriam Cuatrecasas, Juan Acevedo, Luis Hernández, Sandra Maisterra, Marco Bustamante-Balén, Luísa Castro, Antonio Z. Gimeno-García, and J Díaz-Tasende
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Adult ,Male ,medicine.medical_specialty ,Colorectal cancer ,Colonoscopy ,Indigo Carmine ,Chromoendoscopy ,03 medical and health sciences ,0302 clinical medicine ,Crohn Disease ,Positive predicative value ,Humans ,Medicine ,Prospective Studies ,Coloring Agents ,Early Detection of Cancer ,Aged ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Middle Aged ,Inflammatory Bowel Diseases ,medicine.disease ,Ulcerative colitis ,Surgery ,Clinical trial ,Dysplasia ,030220 oncology & carcinogenesis ,Colitis, Ulcerative ,Education, Medical, Continuing ,Female ,030211 gastroenterology & hepatology ,Clinical Competence ,Radiology ,Colorectal Neoplasms ,business ,Precancerous Conditions ,Learning Curve ,Cohort study - Abstract
ObjectiveOutside clinical trials, the effectiveness of chromoendoscopy (CE) for long-standing IBD surveillance is controversial. We aimed to assess the effectiveness of CE for neoplasia detection and characterisation, in real-life.DesignFrom June 2012 to 2014, patients with IBD were prospectively included in a multicentre cohort study. Each colonic segment was evaluated with white light followed by 0.4% indigo carmine CE. Specific lesions' features were recorded. Optical diagnosis was assessed. Dysplasia detection rate between expert and non-expert endoscopists and learning curve were ascertained.ResultsNinety-four (15.7%) dysplastic (1 cancer, 5 high-grade dysplasia, 88 low-grade dysplasia) and 503 (84.3%) non-dysplastic lesions were detected in 350 patients (47% female; mean disease duration: 17 years). Colonoscopies were performed with standard definition (41.5%) or high definition (58.5%). Dysplasia miss rate with white light was 40/94 (57.4% incremental yield for CE). CE-incremental detection yield for dysplasia was comparable between standard definition and high definition (51.5% vs 52.3%, p=0.30). Dysplasia detection rate was comparable between expert and non-expert (18.5% vs 13.1%, p=0.20). No significant learning curve was observed (8.2% vs 14.2%, p=0.46). Sensitivity, specificity, and positive and negative predictive values for dysplasia optical diagnosis were 70%, 90%, 58% and 94%, respectively. Endoscopic characteristics predictive of dysplasia were: proximal location, loss of innominate lines, polypoid morphology and Kudo pit pattern III–V.ConclusionsCE presents a high diagnostic yield for neoplasia detection, irrespectively of the technology and experience available in any centre. In vivo, CE optical diagnosis is highly accurate for ruling out dysplasia, especially in expert hands. Lesion characteristics can aid the endoscopist for in situ therapeutic decisions.Trial registration numberNCT02543762.
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- 2018
25. Su1727 LOW INCIDENCE OF ADVANCED NEOPLASIA IN SERRATED POLYPOSIS SYNDROME AFTER (SUB)TOTAL COLECTOMY - RESULTS FROM A 5-YEAR INTERNATIONAL PROSPECTIVE COHORT STUDY
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Niels van Lelyveld, Willemijn de Klaver, Daniel Rodríguez-Alcalde, Xavier Bessa, Willem A. Bemelman, JJ Koornstra, Barbara A. J. Bastiaansen, Manon C.W. Spaander, Maria Pellise, Joep E. G. IJspeert, Francesc Balaguer, Yasmijn van Herwaarden, Luis Bujanda, Sabela Carballal, Monique E. van Leerdam, Gerhard Jung, Tanya M. Bisseling, Evelien Dekker, Liseth Rivero, Iris D. Nagtegaal, Francisco Rodríguez-Moranta, and Arne Bleijenberg
- Subjects
medicine.medical_specialty ,Total Colectomy ,business.industry ,Internal medicine ,Incidence (epidemiology) ,Gastroenterology ,medicine ,Radiology, Nuclear Medicine and imaging ,Prospective cohort study ,business ,Serrated polyposis - Published
- 2019
26. 481 INDIVIDUALIZED SURVEILLANCE FOR SERRATED POLYPOSIS SYNDROME: RESULTS FROM A PROSPECTIVE 5-YEAR INTERNATIONAL COHORT STUDY
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JJ Koornstra, Xavier Bessa, Francesc Balaguer, Joep E. G. IJspeert, Barbara A. J. Bastiaansen, Yasmijn van Herwaarden, Maria Pellise, Niels van Lelyveld, Willemijn de Klaver, Manon C.W. Spaander, Luis Bujanda, Monique E. van Leerdam, Gerhard Jung, Tanya M. Bisseling, Sabela Carballal, Evelien Dekker, Liseth Rivero, Iris D. Nagtegaal, Francisco Rodríguez-Moranta, and Arne Bleijenberg
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Pediatrics ,medicine.medical_specialty ,business.industry ,Gastroenterology ,Medicine ,Radiology, Nuclear Medicine and imaging ,business ,Serrated polyposis ,Cohort study - Published
- 2019
27. Colorectal cancer risk factors in patients with serrated polyposis syndrome: a large multicentre study
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Mariano González, Maria Liz Leoz, María López-Cerón, Eloisa Moya, Francesc Balaguer, Daniel Rodríguez-Alcalde, Inés Castro, Pilar Esteban, Liseth Rivero-Sánchez, Enrique Quintero, Luis Bujanda, Lucía Cid, Virginia Piñol, Victoria Gonzalo, Rodrigo Jover, Jorge López-Vicente, Joaquín Cubiella, Xavier Bessa, Maria Pellise, Antoni Castells, Lorena Rodríguez, Francisco Rodríguez-Moranta, Joan Clofent, Luis Hernández, Susana Oquiñena, Sabela Carballal, Leticia Moreira, Carmen Poves, Miriam Cuatrecasas, and F. Fernandez
- Subjects
Splenic flexure ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Colorectal cancer ,Incidence (epidemiology) ,Gastroenterology ,Colonoscopy ,Retrospective cohort study ,medicine.disease ,digestive system diseases ,03 medical and health sciences ,0302 clinical medicine ,Dysplasia ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,030211 gastroenterology & hepatology ,Risk assessment ,business ,Cohort study - Abstract
Objective Serrated polyposis syndrome (SPS) is associated with an increased colorectal cancer (CRC) risk, although the magnitude of the risk remains uncertain. Whereas intensive endoscopic surveillance for CRC prevention is advised, predictors that identify patients who have high CRC risk remain unknown. We performed a multicentre nationwide study aimed at describing the CRC risk in patients with SPS and identifying clinicopathological predictors independently associated with CRC. Design From March 2013 through September 2014, patients with SPS were retrospectively recruited at 18 Spanish centres. Data were collected from medical, endoscopy and histopathology reports. Multivariate logistic regression was performed to identify CRC risk factors. Results In 296 patients with SPS with a median follow-up time of 45 months (IQR 26–79.7), a median of 26 (IQR 18.2–40.7) serrated polyps and 3 (IQR 1–6) adenomas per patient were detected. Forty-seven patients (15.8%) developed CRC at a mean age of 53.9±12.8, and 4 out of 47 (8.5%) tumours were detected during surveillance (cumulative CRC incidence 1.9%). Patients with >2 sessile serrated adenomas/polyps (SSA/Ps) proximal to splenic flexure and ≥1 proximal SSA/P with high-grade dysplasia were independent CRC risk factors (incremental OR=2, 95% CI 1.22 to 3.24, p=0.006). Patients with no risk factors showed a 55% decrease in CRC risk (OR=0.45, 95% CI 0.24 to 0.86, p=0.01). Conclusions Patients with SPS have an increased risk of CRC, although lower than previously published. Close colonoscopy surveillance in experienced centres show a low risk of developing CRC (1.9% in 5 years). Specific polyp features (SSA/P histology, proximal location and presence of high-grade dysplasia) should be used to guide clinical management.
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- 2015
28. Hereditary colorectal cancer syndromes
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Maria Liz Leoz, Sabela Carballal, Teresa Ocaña, Leticia Moreira, and Francesc Balaguer
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Oncology ,medicine.medical_specialty ,Pathology ,medicine.diagnostic_test ,business.industry ,Colorectal cancer ,Gastroenterology ,Cancer ,Diagnostic evaluation ,medicine.disease ,digestive system diseases ,Natural history ,Germline mutation ,Internal medicine ,medicine ,Genomic information ,Personalized medicine ,business ,Genetic testing - Abstract
SUMMARY Colorectal cancer (CRC) is one of the most common malignancies and the second-leading cause of cancer death in both sexes in developed countries. Over the last 25 years, highly penetrant monogenic germline mutations that predispose to CRC and other digestive tumors have been identified, accounting for up to 5% of all CRC cases. Identification and characterization of these disorders have allowed modification of their natural history, with a substantial decrease in morbidity and mortality among high-risk patients. Recognizing hereditary CRC has also impacted predictive genetic testing and personalized medicine based on genomic information. This review summarizes the current knowledge on hereditary CRC regarding pathogenesis, clinical features, diagnostic evaluation and management recommendations.
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- 2014
29. 397 ENDOCUFF® ASSISTED COLONOSCOPY VERSUS STANDARD COLONOSCOPY IN THE SURVEILLANCE OF SERRATED POLYPOSIS SYNDROME. A MULTICENTER, RANDOMIZED AND CONTROLLED TRIAL
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Luis Hernández, Teresa Ocaña, Sabela Carballal, Maria Pellise, Josep Llach, Ariadna Sánchez, Ignasi Puig, Jorge López-Vicente, Coral Arnau Colell, Francesc Balaguer, Mireia Diaz, Leticia Moreira, Liseth Rivero Sanchez, Miriam Cuatrecasas, Lorena Moreno, and Cristina Rodríguez de Miguel
- Subjects
medicine.medical_specialty ,Randomized controlled trial ,medicine.diagnostic_test ,law ,business.industry ,Gastroenterology ,medicine ,Colonoscopy ,Radiology, Nuclear Medicine and imaging ,business ,Serrated polyposis ,law.invention ,Surgery - Published
- 2018
30. Serrated Polyps and Serrated Polyposis Syndrome
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Sabela Carballal, Francesc Balaguer, and Leticia Moreira
- Subjects
medicine.medical_specialty ,Intestinal Polyposis ,business.industry ,Colorectal cancer ,General Engineering ,Colonic Polyps ,Syndrome ,medicine.disease_cause ,medicine.disease ,Malignancy ,Gastroenterology ,Serrated polyposis ,digestive system diseases ,Malignant transformation ,Hyperplastic Polyp ,Dysplasia ,Internal medicine ,Humans ,Medicine ,Colorectal Neoplasms ,business ,Carcinogenesis ,Precancerous Conditions ,Sessile serrated adenoma - Abstract
Serrated polyps of the colorectum are a heterogeneous group of lesions with potential malignant transformation through the «serrated pathway» of carcinogenesis. The discovery of these lesions has been a paradigm shift in the concept of the adenoma-carcinoma sequence, so that up to 30% of tumors develop through this pathway. The main factors associated with an increased risk of malignancy in serrated polyps are size≥10mm, multiplicity, sessile serrated adenoma histology, presence of associated dysplasia and proximal location. Current evidence indicates that these lesions should be resected completely, and the patient requires an endoscopic surveillance program. Serrated polyposis syndrome is a clinicopathological entity characterized by multiple and/or large serrated polyps with an increased risk of developing colorectal cancer. These patients and their families, require multidisciplinary assessment in specialized high risk colorectal cancer units.
- Published
- 2013
31. 1067 - Analysis of Methylation Field Defect in Serrated Polyposis Syndrome
- Author
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Juan José Lozano, Miriam Cuatrecasas, Lorena Moreno, Eva Hernández-Illán, Sabela Carballal, Francesc Balaguer, Mireia Diaz, Gerhard Jung, Liseth Rivero, Jenifer Muñoz, Maria Pellise, Teresa Ocaña, Ariadna Sánchez, and Antoni Castells
- Subjects
Nuclear magnetic resonance ,Materials science ,Hepatology ,Field (physics) ,Gastroenterology ,Methylation ,Serrated polyposis - Published
- 2018
32. Mo1736 - Identification of Clinical, Genetic and Endoscopic Predictors of Incident Colorectal Cancer in Lynch Syndrome
- Author
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Elena Aguirre, Daniel Rodríguez-Alcalde, Xavier Bessa, Liseth Rivero, Lorena Rodríguez-Alonso, Gemma Llort, Carme Yagüe, Virginia Piñol, Marta Carrillo-Palau, Adolfo Suárez, Matilde Navarro, Maria Pellise, Ariadna Sánchez, Lorena Moreno, Andres Dacal, Leticia Moreira, Eva Martínez de Castro, Marta Ponce, Esteban Saperas, Angeles Pizarro, Carmen Poves, Inmaculada Salces, Teresa Ocaña, Laura Rivas, Catalina Garau, Sabela Carballal, Adrià Lopez Fernandez, Marta Garzon, Joan Brunet, Maite Herraiz, Teresa Ramón y Cajal, Cristina de la Peña Álvarez, Alexandra Gisbert-Beamud, Francesc Balaguer, Luis Bujanda, Antoni Castells, Lucía Cid, J. Balmaña, María Dolores Picó, Rodrigo Jover, Miquel Serra-Burriel, Gabriel Capellá, Francisco Rodríguez-Moranta, Joaquín Cubiella, and Marta Pineda
- Subjects
Oncology ,medicine.medical_specialty ,Hepatology ,Colorectal cancer ,business.industry ,Internal medicine ,Gastroenterology ,medicine ,Clinical genetic ,Identification (biology) ,medicine.disease ,business ,Lynch syndrome - Published
- 2018
33. Mo1978 - Comprehensive Analysis of Methylation Field Defect in Colorectal Carcinogenesis
- Author
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Juan José Lozano, Antoni Castells, Ariadna Sánchez, Maria Vila-Casadesús, Sabela Carballal, Jordi Camps, Adela Castillejo, Mar Giner-Calabuig, Gerhard Jung, Miriam Cuatrecasas, Francesc Balaguer, Miren Alustiza, Cristina Alenda, Rodrigo Jover, José Luis Soto, Miriam Juárez, Eva Hernández-Illán, Lorena Moreno, Maria Pellise, Liseth Rivero, Isabel Quintanilla, and Jenifer Muñoz
- Subjects
Hepatology ,Field (physics) ,Gastroenterology ,Cancer research ,Methylation ,Colorectal carcinogenesis ,Biology - Published
- 2018
34. PRESICION EN LA ESTIMACION DEL TAMAÑO DE LOS POLIPOS POR LOS ENDOSCOPISTAS
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Maria Liz Leoz, Miriam Cuatrecasas, L Aguilera, Sabela Carballal, Isis K. Araujo, D Avila Carpio Ansel, Joan Llach, Maria Pellise, Elena Ricart, and Liseth Rivero-Sánchez
- Subjects
business.industry ,Gastroenterology ,Medicine ,business ,Humanities - Published
- 2015
35. UNA COLONOSCOPIA DE REVISIÓN AUMENTA EL RENDIMIENTO EN EL DIAGNÓSTICO DE SÍNDROME DE POLIPOSIS SERRADA EN POBLACIÓN DE CRIBADO DE CÁNCER COLORRECTAL
- Author
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Sabela Carballal, Anna Serradesanferm, Joan Llach, Cristina Hernández, Maria Pellise, Miriam Cuatrecasas, Francesc Balaguer, Liseth Rivero-Sánchez, Angels Pozo, Antoni Castells, Leticia Moreira, María López-Cerón, and Xavier Bessa
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,Gastroenterology ,medicine ,business - Published
- 2015
36. Sa1599 Second Look Colonoscopy Increases the Yield of Serrated Polyposis Syndrome Diagnosis in Ccr Screening Population
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Anna Serradesanferm, Liseth Rivero-Sánchez, Maria Pellise, Josep Llach, Francesc Balaguer, Miriam Cuatrecasas, Sabela Carballal, Leticia Moreira, Xavier Bessa, María López-Cerón, M. Angeles Pozo Fernandez, Antoni Castells, and Cristina Hernández
- Subjects
medicine.medical_specialty ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Yield (finance) ,Population ,Gastroenterology ,Colonoscopy ,Serrated polyposis ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,education ,business - Published
- 2015
37. 1065 Incidence of Colonic Neoplasia in Patients With Serrated Polyposis Syndrome Who Undergo Endoscopic Surveillance: A Multicenter Study
- Author
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Daniel Rodríguez-Alcalde, Mariano González, Sabela Carballal, Carmen Poves, Virginia Piñol, Rodrigo Jover, Maria Pellise, Joaquín Cubiella, Antoni Castells, Jorge López-Vicente, Francesc Balaguer, Leticia Moreira, Luis Bujanda, Francisco Rodríguez-Moranta, Inés Castro, Liseth Rivero Sanchez, Victoria Gonzalo, Enrique Quintero, Lorena Rodríguez, Susana Oquiñena, Joan Clofent, María López-Cerón, Xavier Bessa, Francisco J. Martín Fernández, Eloisa Moya, Luis Hernández, Esteve Saperas, Pilar Esteban, Lucía Cid, Miriam Cuatrecasas, and Maria Liz Leoz
- Subjects
medicine.medical_specialty ,Hepatology ,Multicenter study ,business.industry ,Internal medicine ,Incidence (epidemiology) ,Gastroenterology ,medicine ,In patient ,business ,Serrated polyposis - Published
- 2016
38. Su1943 Colorectal Cancer Risk Factors in Patients With Serrated Polyposis Syndrome: Results From a Multicenter Nation-Wide Study
- Author
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Francisco J. Martín Fernández, Victoria Gonzalo, Joaquín Cubiella, Francisco Rodríguez-Moranta, Montserrat Andreu, Mariano Gonzalez-Haba Ruiz, Anna Baiges, Xavier Bessa, Maria Liz Leoz, Teresa Ocaña, Inés Castro, Susana Oquiñena, Sabela Carballal, Luis Hernández, Enrique Quintero, Virginia Piñol, María López-Cerón, Antoni Castells, Juan Clofent, Daniel Rodriguez Alcalde, Pilar Esteban, Maria Pellise, Leticia Moreira, Jorge Lopez, Vicent Hernandez, Maria Varela, Juan Diego Morillas, Miriam Cuatrecasas, Rodrigo Jover, Francesc Balaguer, Luis Bujanda, Lorena Rodriguez Alonso, Angel Barturen, Eloisa Moya, and Liseth Rivero-Sánchez
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Oncology ,medicine.medical_specialty ,Hepatology ,business.industry ,Colorectal cancer ,Internal medicine ,Gastroenterology ,medicine ,In patient ,business ,medicine.disease ,Serrated polyposis - Published
- 2015
39. High prevalence of serrated polyposis syndrome in FIT-based colorectal cancer screening programmes: Table 1
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Anna Serradesanferm, Teresa Ocaña, Montserrat Andreu, Francesc Balaguer, Maria Pellise, Sabela Carballal, Xavier Bessa, Leticia Moreira, Francesc Macià, Antoni Castells, and Jaume Grau
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medicine.medical_specialty ,Average risk ,High prevalence ,business.industry ,Colorectal cancer ,Gastroenterology ,medicine.disease ,Serrated polyposis ,digestive system diseases ,Screening programme ,Colorectal cancer screening ,Internal medicine ,Medicine ,Who criteria ,business ,Blood testing - Abstract
Serrated polyposis syndrome (SPS) is a recently recognised high risk condition for colorectal cancer (CRC) characterised by the presence of large and/or multiple serrated polyps in the colon.1 ,2 The prevalence of SPS has been previously estimated out of CRC endoscopy-based screening programmes on average risk individuals; in this setting, the prevalence ranged from 0.033% (1/3000 sigmoidoscopies)3 to 0.055% (1/1818 colonoscopies).4 However, Biswas et al 5 recently published a higher prevalence based on a guaiac faecal occult blood testing (gFOBT) CRC screening programme in the UK (NHS Bowel Cancer Screening Programme). In this programme, between April 2010 and January 2012, 5/755 (0.66%) patients attended for index screening colonoscopy after a positive gFOBT met the WHO criteria for SPS, which represented a 20-fold increase …
- Published
- 2012
40. 671 Risk of Advanced Neoplasm in Individuals With Family History of Colorectal Cancer
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Anna Baiges, Teresa Ocaña, Maria Liz Leoz, Leticia Moreira, Antoni Castells, María López-Cerón, Francesc Balaguer, Maria Pellise, Sabela Carballal, and Raquel Rodriguez
- Subjects
Oncology ,medicine.medical_specialty ,Hepatology ,Colorectal cancer ,business.industry ,Internal medicine ,Gastroenterology ,medicine ,Neoplasm ,Family history ,medicine.disease ,business - Published
- 2014
41. Tu1523 Results of a Chromoendoscopy - Based Surveillance Program for Long-Standing Colonic Inflammatory Bowel Disease
- Author
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Cristina Rodríguez de Miguel, Sabela Carballal, Antoni Castells, Anna Baiges, Ivan Romero, Miriam Cuatrecasas, Elena Ricart, Maria Pellise, Josep Llach, Marta Ubre, Ingrid Ordás, Leticia Moreira, María López-Cerón, Isabel Quintanilla, Francesc Balaguer, and Julián Panés
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,Gastroenterology ,medicine ,Radiology, Nuclear Medicine and imaging ,medicine.disease ,business ,Inflammatory bowel disease ,Chromoendoscopy - Published
- 2014
42. 107 Somatic MLH1 Promoter Hypermethylation Is a Frequent Event in Lynch Syndrome Colorectal Cancers
- Author
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Teresa Ocaña, C. Richard Boland, Antoni Castells, Francesc Balaguer, Sabela Carballal, Angel Carracedo, Rodrigo Jover, Montserrat Andreu, Maria Liz Leoz, Miriam Cuatrecasas, Ajay Goel, Mildred Arnold, Patricia Fernandez, Jenifer Muñoz, Xavier Llor, Isabel Quintanilla, Maria Pellise, and Leticia Moreira
- Subjects
Hepatology ,Promoter hypermethylation ,business.industry ,Somatic cell ,Event (relativity) ,Gastroenterology ,medicine ,Cancer research ,MLH1 ,medicine.disease ,business ,Lynch syndrome - Published
- 2013
43. Su1084 Clinicopathological Characterization of Serrated Polyposis Syndrome
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María López-Cerón, Teresa Ocaña, Maria Liz Leoz, Daniel Rodríguez-Alcalde, Antoni Castells, Miriam Cuatrecasas, Sabela Carballal, Francesc Balaguer, Maria Pellise, Patricia Fernandez, and Leticia Moreira
- Subjects
medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,Adenoma ,business.industry ,Colorectal cancer ,medicine.medical_treatment ,Incidence (epidemiology) ,Gastroenterology ,Colonoscopy ,medicine.disease ,Serrated polyposis ,Polypectomy ,Internal medicine ,Relative risk ,medicine ,Risk assessment ,business - Abstract
Background. Post polypectomy surveillance colonoscopies are a huge burden on healthcare systems. Improved risk assessment could result in reduced colonoscopy use. Our aim was to identify patient, polyp and program factors associated with incidence of new neoplasia at first surveillance colonoscopy following an initial diagnosis of colorectal adenomaMethods. We reviewed colorectal cancer (CRC) surveillance outcome data contained in a colonoscopy recall database. Findings at first surveillance colonoscopy in people who had been diagnosed with advanced (high risk, HRA) adenoma ( ≥ 3 polyps, size ≥10mm, villous component, serration, high grade dysplasia) at diagnostic colonoscopy were compared to those with non-advanced (low risk, LRA) adenomas at diagnosis. Data included patient age and sex, polyp features and location, and interval between colonoscopies. Outcomes were compared using bivariate (Fisher's exact) and multivariate (multinomial logistic regression) analyses. Results. Among 457 eligible patients, 266 (58%) were males, and mean age at diagnostic colonoscopy was 63 years. Mean time between diagnostic and surveillance colonoscopy were 43 and 31 months (median 40 and 35 months) for HRA and LRA respectively. There was a significant difference between groups for outcome at surveillance (Table, p=0.014). At the multivariate level, significant associations between outcome at surveillance and polyp features at diagnosis were limited. Controlling for age, gender and colonoscopy interval, those with LRA at diagnosis were more likely to have LRA at surveillance (RRR=1.91, p= 0.023, 95% CI 1.09-3.34). There was a non-significant trend towards increased risk for advanced neoplasia (HRA plus cancers) at surveillance in those originally diagnosed with HRA (RRR=1.31). Age and sex were significant predictors of adenoma incidence at surveillance. Relative risk ratios for HRA increased with each year of age for both males (RRR 1.04, p=0.007, 95% CI 1.01-1.07) and females (RRR 1.04, p=0.019, 95% CI 1.01-1.07), while the relative risk ratio for LRA increased significantly per year of age for males only (RRR 1.03, p=0.007, 95% CI 1.01-1.06). Conclusions: While features of polyps at diagnostic colonoscopies remain key predictors of findings at surveillance, age and sex are additional variables that predict worse outcome. Reduced risk of LRA at surveillance in patients previously diagnosed with HRA may reflect a more conscientious approach by proceduralists at diagnosis. Post polypectomy surveillance could focus more towards older patients. Table. Surveillance outcomes following a diagnosis of low or high risk adenoma.
- Published
- 2013
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