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Baseline Surveillance in Li-Fraumeni Syndrome Using Whole-Body Magnetic Resonance Imaging: A Meta-analysis.

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Date
2017-12
ICR Author
Eeles, Rosalind
Marsden,
Author
Ballinger, ML
Best, A
Mai, PL
Khincha, PP
Loud, JT
Peters, JA
Achatz, MI
Chojniak, R
Balieiro da Costa, A
Santiago, KM
Garber, J
O'Neill, AF
Eeles, RA
Evans, DG
Bleiker, E
Sonke, GS
Ruijs, M
Loo, C
Schiffman, J
Naumer, A
Kohlmann, W
Strong, LC
Bojadzieva, J
Malkin, D
Rednam, SP
Stoffel, EM
Koeppe, E
Weitzel, JN
Slavin, TP
Nehoray, B
Robson, M
Walsh, M
Manelli, L
Villani, A
Thomas, DM
Savage, SA
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Type
Journal Article
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Abstract
Importance Guidelines for clinical management in Li-Fraumeni syndrome, a multiple-organ cancer predisposition condition, are limited. Whole-body magnetic resonance imaging (WBMRI) may play a role in surveillance of this high-risk population.Objective To assess the clinical utility of WBMRI in germline TP53 mutation carriers at baseline.Data sources Clinical and research surveillance cohorts were identified through the Li-Fraumeni Exploration Research Consortium.Study selection Cohorts that incorporated WBMRI for individuals with germline TP53 mutations from January 1, 2004, through October 1, 2016, were included.Data extraction and synthesis Data were extracted by investigators from each cohort independently and synthesized by 2 investigators. Random-effects meta-analysis methods were used to estimate proportions.Main outcomes and measures The proportions of participants at baseline in whom a lesion was detected that required follow-up and in whom a new primary malignant neoplasm was detected.Results A total of 578 participants (376 female [65.1%] and 202 male [34.9%]; mean [SD] age, 33.2 [17.1] years) from 13 cohorts in 6 countries were included in the analysis. Two hundred twenty-five lesions requiring clinical follow-up were detected by WBMRI in 173 participants. Sixty-one lesions were diagnosed in 54 individuals as benign or malignant neoplasms. Overall, 42 cancers were identified in 39 individuals, with 35 new localized cancers treated with curative intent. The overall estimated detection rate for new, localized primary cancers was 7% (95% CI, 5%-9%).Conclusions and relevance These data suggest clinical utility of baseline WBMRI in TP53 germline mutation carriers and may form an integral part of baseline clinical risk management in this high-risk population.
URI
https://repository.icr.ac.uk/handle/internal/909
DOI
https://doi.org/10.1001/jamaoncol.2017.1968
Collections
  • Genetics and Epidemiology
  • Radiotherapy and Imaging
Subject
Humans
Li-Fraumeni Syndrome
Diagnosis, Differential
Magnetic Resonance Imaging
Population Surveillance
Mutation
Adolescent
Adult
Middle Aged
Female
Male
Tumor Suppressor Protein p53
Whole Body Imaging
Practice Guidelines as Topic
Early Detection of Cancer
Young Adult
Research team
Oncogenetics
Language
eng
Date accepted
2017-05-15
License start date
2017-12
Citation
JAMA oncology, 2017, 3 (12), pp. 1634 - 1639

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