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Dye-Based Chromoendoscopy in Patients With Lynch Syndrome: An Individual Patient Data Meta-Analysis of Randomized
Britt B S L Houwen1, Nahid Mostafavi, Jasper L A Vleugels
11Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam Cancer Center, University of Amsterdam, Amsterdam, the Netherlands; 2Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands; 3Department of Internal Medicine, University of Bonn, Bonn, Germany; 4National Center for Hereditary Tumor Syndromes, University Hospital Bonn, Bonn, Germany; 5Department of Hematology and Oncology, Klinikum Coburg, Coburg, Germany; 6Department of Gastroenterology, Hospital Clinic of Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universitat de Barcelona, Barcelona, Spain; 7Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA; 8Division of Gastroenterology and Hepatology, Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; 9Division of Cancer Genetics and Prevention, Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA; 10Harvard Medical School, Boston, Massachusetts, USA; 11Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; 12Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, Radboud University of Nijmegen, Nijmegen, the Netherlands.
Introduction:
The additional diagnostic value of dye-based chromoendosocpy (CE) for surveillance of patients with Lynch syndrome is subject of debate.
Methods:
To clarify this debate, we performed an individual patient data meta-analysis of randomized studies that compared CE with WLE for the detection of adenomas in patients with Lynch syndrome.
Results:
Three randomized studies comprising 533 patients were included. The adenoma detection rate was 74/265 (28%) in patients randomized to WLE compared with 83/266 (31%) in patients randomized to CE (odds ratio 1.17; 95% confidence interval 0.81-1.70).
Discussion:
Based on low-quality evidence, CE showed no apparent increase in adenoma detection compared to WLE during surveillance of patients with Lynch syndrome.
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