European guidelines for #Lynchsyndrome by @EHTG_Tweets and @escp_tweets online (part). See the executive summary available @BJSurgery Thank you @GabrielaMoslein @IonutNegoi @AndyLatchford @mev_dv @ProfEmmaCrosbie @neilajryan @CaPP3 @ASampaioSoares https://t.co/cFooj4sH6u

🚨 Big step forward in cancer research! The EU has awarded €13.6M to the international PREDI-LYNCH project to boost early detection of Lynch syndrome-related cancers. Tampere University is proud to be one of the key partners in this important initiative. https://t.co/K9SwerTvwf

New trial coming up - PROSPERITY trial comparing protective ileostomy versus colostomy in anterior rectal resection. Presented at @escp_tweets. Protocol now out in @BMJ_Open! Trial is open for new centers also! Contact @LauraKoskenvuo if interested! https://t.co/8ALQMA2wGm

12/ 🌍 Massive credit to the PLSD team: @k_zalevskaja @PLSDatabase 🧪 25 countries 📈 8000+ carriers 🧠 Prospectively stratified by gene & surgery 📢 This data should guide the next round of guideline updates. 🧵/end 🔗 Read the paper @BJSurgery

11/ 📣 For clinicians: If LS is confirmed pre-op, discuss: ✅ Risk of metachronous CRC ✅ Surveillance burden ✅ Surgical complications ✅ Functional outcomes 🧬 This is precision surgery — based on real risk.

10/ 🔄 This challenges past thinking: 2017 PLSD: No extra risk after first CRC 2025 PLSD: Higher risk after first CRC 🔁 It's time to rethink surgical strategies — especially for MSH6 carriers

9/ 🧠 Implication: 🔹 Prior CRC ≠ cleared danger 🔹 It’s actually a marker of higher ongoing risk 🔹 Segmental resection leaves too much colon behind for some 🔹 Even MSH6 may benefit from extended resection — contrary to guidelines

8/ 🧍‍♂️ So why no survival benefit? Extended surgery didn’t improve 15-year survival vs segmental. But fewer metachronous CRCs = • Fewer operations • Less surveillance burden • Potentially better quality of life Risk — not survival — is the key metric here.

7/ 💣 And if patients had segmental resection: • MLH1: 69.1% • MSH2: 65.4% • MSH6: 31.9% 🚨 But extended resection dramatically reduced risk: • MLH1: 25.1% • MSH2: 14.7% • MSH6: 0% (among 11 patients)

6/ 📈 By age 75: 🟢 First CRC risk: • MLH1: 49.9% • MSH2: 45.8% • MSH6: 17.4% 🔴 Metachronous CRC risk in those with prior CRC: • MLH1: 52.5% • MSH2: 53.4% • MSH6: 30.8% 🔺 Yes — having had CRC increases your future CRC risk.

5/ 🔥 Core finding: Patients with prior CRC had equal or higher risk of developing a second CRC than those who had never had CRC. 🧨 This overturns previous PLSD findings and assumptions that resection + surveillance were enough.

4/ 👥 The study: 8438 path_MMR carriers ▶️ 65,370 person-years of prospective follow-up 🧬 MLH1: 37%, MSH2: 37%, MSH6: 19% BUT: Surgical data were available for only a subset (908 patients) — And that’s where the real insight lies.

3/ ⚔️ Surgical options: • Segmental resection: only the tumor segment is removed (e.g. hemicolectomy) • Extended colectomy: most or all of the colon is removed Guidelines favor extended resection for MLH1/MSH2 — but recommend segmental resection for MSH6/PMS2. Is this enough?

2/ 📌 Lynch syndrome (LS) = inherited cancer risk from MMR gene variants (MLH1, MSH2, MSH6, PMS2). Colonoscopic surveillance reduces cancer mortality — But LS patients still get CRC. What’s the best surgical approach after the first tumor?

🧵1/ 🚨 Just out: the PLSD's biggest prospective study yet on Lynch syndrome & colorectal cancer (CRC) surgery. What’s the real risk of a second CRC—and can surgery prevent it? Spoiler: Prior CRC = higher risk. Extended surgery = game changer. 👇 🔗

Tutkimusryhmämme rekrytoi *projektipäällikköä* ohjaamaan kliinisiä ja translationaalisia monikeskustutkimuksia. Hae mukaan tiimiin! https://t.co/K20rnZRJKx

Excited to share our urine tumor DNA assay #UroScout results published today in @EUplatinum 👉 https://t.co/1dDoAWOOWf Sensitive Detection of Urothelial Cancer via High-volume Urine DNA Analysis 🧬 497 urine DNA samples from 281 patients ✅100% sens for ≥T1 bladder cancer ✅

presentation of our upcoming PROSPERITY trial at #escp2024 by @LauraKoskenvuo @villesallinen @Adductor

New @TheLancet - Adam et al - Liver transplantation plus chemotherapy versus chemotherapy alone in patients with permanently unresectable colorectal liver metastases (TransMet trial) https://t.co/05kYRbhSBK #CRCSM #LiverTwitter

MSc @SievanenTero defended his PhD thesis today @JYUsport_health on ”The associations of circulating microRNAs and lifestyle habits with cancer risk in #Lynchsyndrome ”. The honorable opponent Arto Mannermaa @UniEastFinland, kustos @eija_laakkonen @gerec_fi #Y-EHTG

Join us at the EHTG Meeting 2024 for a pivotal session on cancer prevention. Don’t miss the opportunity to hear Matthias Kloor as he delves into pioneering immune prevention strategies for Lynch syndrome, revealing how we can utilize the immune system to prevent hereditary cancer