QUESTION UNDER STUDY: To assess whether patient or adenoma characteristics at index colonoscopy could be predictors of metachronous adenomas and of advanced metachronous adenomas at first surveillance colonoscopy. METHODS: This retrospective study evaluated polypectomies of 372 adenomas in 214 patients who underwent a first follow-up colonoscopy after a median of 17 months. Logistic regression analysis was used to assess the association of baseline patient and adenoma characteristics with the development of any metachronous adenomas and of advanced adenomas (>1.0 cm, or villous component, or severe dysplasia, or early cancer). RESULTS: Eighty-one patients (38%) demonstrated 130 metachronous adenomas including 21 cases (10%) with advanced adenomas. The presence of more than 2 baseline adenomas was significantly associated with the finding of adenomas at follow-up (odds ratio 2.44, 95% confidence interval 1.27-4.68, p = 0.010). Patient age (>or= 60 versus <60) and size of largest adenoma (>1.0 cm versus <or= 1.0 cm) demonstrated borderline significance. However, neither gender, most advanced histology (tubulo-villous/villous versus tubular), nor most advanced dysplasia (severe/early cancer versus mild/moderate) at baseline colonoscopy were related with the development of metachronous adenomas. Furthermore, none of the analysed patient and polyp characteristics demonstrated an association with the development of advanced metachronous adenomas. CONCLUSION: Patients with over 2 adenomas at baseline colonoscopy are at highest risk for the finding of adenomas at follow-up.
QUESTION UNDER STUDY: To assess whether patient or adenoma characteristics at index colonoscopy could be predictors of metachronous adenomas and of advanced metachronous adenomas at first surveillance colonoscopy. METHODS: This retrospective study evaluated polypectomies of 372 adenomas in 214 patients who underwent a first follow-up colonoscopy after a median of 17 months. Logistic regression analysis was used to assess the association of baseline patient and adenoma characteristics with the development of any metachronous adenomas and of advanced adenomas (>1.0 cm, or villous component, or severe dysplasia, or early cancer). RESULTS: Eighty-one patients (38%) demonstrated 130 metachronous adenomas including 21 cases (10%) with advanced adenomas. The presence of more than 2 baseline adenomas was significantly associated with the finding of adenomas at follow-up (odds ratio 2.44, 95% confidence interval 1.27-4.68, p = 0.010). Patient age (>or= 60 versus <60) and size of largest adenoma (>1.0 cm versus <or= 1.0 cm) demonstrated borderline significance. However, neither gender, most advanced histology (tubulo-villous/villous versus tubular), nor most advanced dysplasia (severe/early cancer versus mild/moderate) at baseline colonoscopy were related with the development of metachronous adenomas. Furthermore, none of the analysed patient and polyp characteristics demonstrated an association with the development of advanced metachronous adenomas. CONCLUSION:Patients with over 2 adenomas at baseline colonoscopy are at highest risk for the finding of adenomas at follow-up.
Authors: Mary Ann Greene; Lynn F Butterly; Martha Goodrich; Tracy Onega; John A Baron; David A Lieberman; Allen J Dietrich; Amitabh Srivastava Journal: Gastrointest Endosc Date: 2011-06-12 Impact factor: 9.427
Authors: Sook Hee Chung; Soo Jung Park; Jae Hee Cheon; Mi Sung Park; Sung Pil Hong; Tae Il Kim; Won Ho Kim Journal: J Korean Med Sci Date: 2013-08-28 Impact factor: 2.153