AIM: Colonoscopy to detect and remove polyps has contributed to a reduction in colorectal carcinoma. Three-year follow up is recommended for patients considered to be at high risk (at least three adenomas, adenoma ≥ 1 cm, villous or high-grade features). Our study focused on patients diagnosed with high-grade dysplasia with regard to initial management and follow up. METHOD: A search of patients who had had endoscopic removal of a high-grade adenoma was carried out. Patients with the following were excluded: follow up of < 1 year, polyposis syndromes, prior colon cancer and a diagnosis of adenocarcinoma within 6 months following initial diagnosis. RESULTS: Eighty-three patients treated between 1999 and 2007 for high-grade dysplasia (HGD) in a colorectal adenoma were identified. Over a median follow-up period of 4 years, 53 (64%) developed further adenomatous polyps. Among these, 7% had an adenoma with HGD or an adenocarcinoma. In all these patients, the initial high-grade adenoma was > 1 cm in diameter. Initial follow-up colonoscopy was performed on average 7 months following the initial diagnosis. Ten per cent of patients underwent prophylactic segmental resection, and 6% received argon laser therapy. CONCLUSION: The study demonstrates that patients who have a colorectal adenoma > 1 cm with HGD may be at high risk of developing further adenomas with HGD or carcinoma. Close follow up is warranted.
AIM: Colonoscopy to detect and remove polyps has contributed to a reduction in colorectal carcinoma. Three-year follow up is recommended for patients considered to be at high risk (at least three adenomas, adenoma ≥ 1 cm, villous or high-grade features). Our study focused on patients diagnosed with high-grade dysplasia with regard to initial management and follow up. METHOD: A search of patients who had had endoscopic removal of a high-grade adenoma was carried out. Patients with the following were excluded: follow up of < 1 year, polyposis syndromes, prior colon cancer and a diagnosis of adenocarcinoma within 6 months following initial diagnosis. RESULTS: Eighty-three patients treated between 1999 and 2007 for high-grade dysplasia (HGD) in a colorectal adenoma were identified. Over a median follow-up period of 4 years, 53 (64%) developed further adenomatous polyps. Among these, 7% had an adenoma with HGD or an adenocarcinoma. In all these patients, the initial high-grade adenoma was > 1 cm in diameter. Initial follow-up colonoscopy was performed on average 7 months following the initial diagnosis. Ten per cent of patients underwent prophylactic segmental resection, and 6% received argon laser therapy. CONCLUSION: The study demonstrates that patients who have a colorectal adenoma > 1 cm with HGD may be at high risk of developing further adenomas with HGD or carcinoma. Close follow up is warranted.
Authors: Stephan Rogalla; Krzysztof Flisikowski; Dimitris Gorpas; Aaron T Mayer; Tatiana Flisikowska; Michael J Mandella; Xiaopeng Ma; Kerriann M Casey; Stephen A Felt; Dieter Saur; Vasilis Ntziachristos; Angelika Schnieke; Christopher H Contag; Sanjiv S Gambhir; Stefan Harmsen Journal: Adv Funct Mater Date: 2019-10-10 Impact factor: 18.808
Authors: Jennifer M Kolb; Christine L Molmenti; Swati G Patel; David A Lieberman; Dennis J Ahnen Journal: Am J Gastroenterol Date: 2020-07 Impact factor: 12.045
Authors: Mohamad A Mouchli; Lidia Ouk; Marianne R Scheitel; Alisha P Chaudhry; Donna Felmlee-Devine; Diane E Grill; Shahrooz Rashtak; Panwen Wang; Junwen Wang; Rajeev Chaudhry; Thomas C Smyrk; Ann L Oberg; Brooke R Druliner; Lisa A Boardman Journal: World J Gastroenterol Date: 2018-02-28 Impact factor: 5.742
Authors: Cecilia Högberg; Pontus Karling; Jörgen Rutegård; Mikael Lilja; Thomas Ljung Journal: Scand J Prim Health Care Date: 2013-11-06 Impact factor: 2.581
Authors: Alexander Semaan; Anne van Ellen; Sebastian Meller; Dominik Bergheim; Vittorio Branchi; Philipp Lingohr; Diane Goltz; Jörg C Kalff; Glen Kristiansen; Hanno Matthaei; Dimitrios Pantelis; Dimo Dietrich Journal: Clin Epigenetics Date: 2016-09-20 Impact factor: 6.551