Endoscopy 2019; 51(04): S113-S114
DOI: 10.1055/s-0039-1681505
ESGE Days 2019 oral presentations
Saturday, April 6, 2019 11:00 – 13:00: Best abstract awards Congress Hall
Georg Thieme Verlag KG Stuttgart · New York

HIGH DEFINITION WHITE-LIGHT COLONOSCOPY VERSUS CHROMOENDOSCOPY FOR SURVEILLANCE OF LYNCH SYNDROME. A MULTICENTER, RANDOMIZED, PARALLEL, AND NON-INFERIORITY STUDY (ENDOLYNCH STUDY)

, , On behalf of the EndoCAR group from the Spanish Gastroenterology Association (AEG) and the Spanish Society of Digestive Endoscopy (SEED)
L Rivero-Sánchez
1   Hospital Clinic de Barcelona. Department of Gastroenterology. Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS). Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
,
C Arnau-Collell
2   Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
,
J Herrero
3   Complexo Hospitalario Universitario de Ourense, Department of Gastroenterology, Ourense, Spain
,
D Remedios
3   Complexo Hospitalario Universitario de Ourense, Department of Gastroenterology, Ourense, Spain
,
V Alvarez
4   Complejo Hospitalario de Pontevedra, Department of Gastroenterology, Pontevedra, Spain
,
E Albéniz
5   Complejo Hospitalario de Navarra, Digestive System Service, Endoscopy Unit. Navarrabiomed, Universidad Pública de Navarra, IdiSNa, Pamplona, Spain
,
P Calvo
6   Complejo Hospitalario de Navarra, Nurse High-Risk Clinic, Pamplona, Spain
,
J Gordillo
7   Hospital de la Santa Creu i Sant Pau, Gastroenterology Unit, Barcelona, Spain
,
I Puig
8   Althaia, Xarxa Assistencial Universitària de Manresa, Digestive System Service, Manresa, Spain
,
J López-Vicente
9   Hospital Universitario de Móstoles, Digestive System Service, Móstoles, Spain
,
A Huerta
10   Hospital Galdakao-Usansolo, Department of Gastroenterology, Galdakao, Spain
,
M López-Cerón
11   Hospital Universitario 12 de Octubre, Digestive System Service, Madrid, Spain
,
I Salces
11   Hospital Universitario 12 de Octubre, Digestive System Service, Madrid, Spain
,
B Peñas
12   Hospital Ramón y Cajal, Department of Gastroenterology, Madrid, Spain
,
S Parejo
12   Hospital Ramón y Cajal, Department of Gastroenterology, Madrid, Spain
,
M Herraiz
13   Clínica Universitaria de Navarra, Digestive System Service, Pamplona, Spain
,
A Gimeno
14   Hospital Universitario de Canarias, Digestive System Service, Santa Cruz de Tenerife, Spain
,
E Saperas
15   Hospital General de Catalunya, Digestive System Service, Sant Cugat del Vallès, Spain
,
C Álvarez
16   Hospital del Mar, Digestive System Service, Barcelona, Spain
,
L Moreno
2   Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
,
C Rodriguez de Miguel
2   Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
,
M Díaz
2   Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
,
T Ocaña
17   Hospital Clinic de Barcelona. Department of Gastroenterology, Barcelona, Spain
,
L Moreira
1   Hospital Clinic de Barcelona. Department of Gastroenterology. Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS). Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
,
M Cuatrecasas
18   Departamento de Anatomía Patológica. Hospital Clínic de Barcelona. Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
,
S Carballal
1   Hospital Clinic de Barcelona. Department of Gastroenterology. Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS). Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
,
A Sánchez
1   Hospital Clinic de Barcelona. Department of Gastroenterology. Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS). Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
,
G Jung
1   Hospital Clinic de Barcelona. Department of Gastroenterology. Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS). Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
,
O Ortiz
17   Hospital Clinic de Barcelona. Department of Gastroenterology, Barcelona, Spain
,
A Gavric
17   Hospital Clinic de Barcelona. Department of Gastroenterology, Barcelona, Spain
19   University Medical Center Ljubljana. Department of Gastroenterology and Hepatology, Ljubljana, Slovenia
,
J Llach
17   Hospital Clinic de Barcelona. Department of Gastroenterology, Barcelona, Spain
,
F Balaguer
20   Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
,
M Pellisé
20   Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Adenomas in Lynch syndrome (LS) have an accelerated progression to colorectal cancer. Despite low evidence, clinical guidelines recommend using high-definition and pan-chromoendoscopy (CE) for surveillance in LS. We aimed to compare the adenoma detection rate (ADR) between high-definition white-light endoscopy (WLE) and CE in individuals with LS.

Methods:

Multicenter, randomized and parallel study with high-level detector endoscopists, devoted to high-risk conditions of colorectal cancer. Adults with confirmed mutation (MLH1, MSH2, MSH6, PMS2 and Epcam) were randomized 1:1 to WLE or CE. 244 individuals were required to demonstrate non-inferiority of WLE versus CE (non-inferiority margin of 15%; power 80%; drop-out 10%; significance of 0.025).

Results:

256 subjects were included by 14 Spanish centers. Baseline characteristics (demographic, medical history, genotype) were similar between groups. The ADR for WLE versus CE were 28.1% (95% confidence interval 21.1%-36.4%) versus 34.4% (26.4%-43.3%) respectively (p = 0.281). The detection rate of lesions in WLE versus CE group were as follow: polyps 50.0% versus 57.7% (p = 0.004), serrated lesions 23.4% versus 37.5% (p = 0.015), proximal serrated lesions 10.2% versus 11.7% (p = 0.689), sessile serrated lesions 5.5% versus 3.9% (p = 0.554) and advanced adenomas 7.8% versus 3.9% (p = 0.183) respectively. The mean (± standard deviation) of lesions per patient for WLE versus CE were as follow: adenomas 1.04 (1.37) versus 0.86 (1.04) (p = 0.670), polyps 2.36 (1.77) versus 2.67 (2.29) (p = 0.004), serrated lesions 0.67 (0.89) versus 1.04 (1.38) (p = 0.004), proximal serrated lesions 0.25 (0.56) versus 0.25 (0.61) (p = 0.426), sessile serrated lesions 0.10 (0.31) versus 0.11 (0.67) (p = 0.660) respectively. The total procedural time and withdrawal time (mean ± standard deviation; in minutes) with WLE versus CE were as follow: 22.42 ± 8.72 versus 30.67 ± 12.84 (p < 0.001) and 13.5 ± 5.63 versus 18.37 ± 7.57 (p < 0.001) respectively.

Conclusions:

In a scenario with high-level detector endoscopists, high-definition WLE is an optimal and efficient endoscopic technique for surveillance of LS. CE prolonged the procedural time without increasing detection of relevant lesions.