P25: Preliminary Epidemiological results from the first four months of a pilot interpisciplinary model in identification of GI syndromic neoplasia

Giulia Martina Cavestro1, Federica Calabrese1, Maria Grazia Patricelli2, Annalisa Russo Raucci2, Paola Carrera2, Ugo Elmore3, Andrea Tamburini3, Stefano Crippa4, Monica Ronzoni5, Michele Reni5, Luca Albarello6, Maurizio Ferrari2, Riccardo Rosati3, Massimo Falconi4, Luca Gianni5, Claudio Doglioni6, Giovanni Tonon7, Pier Alberto Testoni1

1 – Gastroenterology and Gastrointestinal Endoscopy Unit, University Vita Salute San Raffeale, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy. 2 – Clinical Molecular Biology and Cytogenetics Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy.3 – Gastrointestinal Surgical Unit, Department of Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy. 4 – Pancreatic Surgery Unit, Department of Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy. 5 – Department of Medical Oncology, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy. 6 – Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy. 7 – Functional Genomics of Cancer Unit, Department of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Aim

BACKGROUND: The best interdisciplinary science comes from the realization that there are pressing questions that cannot be adequately addressed by people from just one discipline. Syndromic cancer identification is one of the main interdisciplinary goals in medicine.

AIM: to apply interdisciplinary clinical work revealing the growth and influence of interdisciplinary research in high-risk patients for syndromic colorectal, gastric and pancreatic cancer. This abstract presents epidemiological results based on analysis of early scientific data returned from the first four months of a interdisciplinary model in identification of GI syndromic neoplasia.

Method

A single centre, multidisciplinary team composed by a geneticist, a surgeon, an oncologist and a pathologist is involved in the patients enrollment and decision process. The project include all individuals who have at least two first-degree relative who developed pancreatic, colorectal and gastric cancer. We propose an initial encounter contact phase with a geneticist in order to better define if the disease has a syndromic inheritance or not. The second summary phase is performed by a gastroenterologist together with the surgeon, oncologist and pathologist in order to provide all the options and decisions for the next clinical diagnostic step.

Results

Analysis of early epidemiological data returned from the first four months of the interdisciplinary model in identification of GI syndromic neoplasia has demonstrated: 60% of the patients (n=42) were sporadic neoplasia. 22% (n=15) were Lynch syndromes, 3 (4%) patients were affected by familial polyposis and 3 patients (4%) were affected by attenuated familial polyposis; 5 patients (7%) were affected by familial pancreatic cancer and 2 (3%) patients were affected by familial gastric cancer.

Conclusion

Syndromic GI tumours are described as less of 20% of all GI tumours. An interdisciplinary approach to GI cancers can better identify syndromic patients driving researchers to ask questions and solve problems that have rarely come up before.

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