Yoon Suk Jung1, Dong Il Park2, Won Hee Kim3, Chang Soo Eun4, Soo-Kyung Park1, Bong Min Ko5, Geom Seog Seo6, Jae Myung Cha7, Jae Jun Park8, Kyeong Ok Kim9, Chang Mo Moon10, Yunho Jung11, Eun Soo Kim12, Seong Ran Jeon13, Chang Kyun Lee14. 1. Department of Internal Medicine, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, 108, Pyung-Dong, Jongro-Ku, Seoul, 110-746, Korea. 2. Department of Internal Medicine, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, 108, Pyung-Dong, Jongro-Ku, Seoul, 110-746, Korea. diksmc.park@samsung.com. 3. Digestive Disease Center, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-712, Korea. ari98@cha.ac.kr. 4. Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea. 5. Department of Internal Medicine, Digestive Disease Center and Research Institute, Soonchunhyang University School of Medicine, Bucheon, Korea. 6. Department of Internal Medicine, Digestive Disease Research Institute, Wonkwang University College of Medicine, Iksan, Korea. 7. Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine, Seoul, Korea. 8. Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. 9. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. 10. Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea. 11. Division of Gastroenterology, Department of Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea. 12. Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Keimyung University, Daegu, Korea. 13. Institute for Digestive Research, Digestive Disease Center, College of Medicine, Soonchunhyang University, Seoul, Korea. 14. Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
Abstract
BACKGROUND: Data regarding outcomes for patients with multiple findings for high-risk adenomas are scarce. AIM: To compare the risk for colorectal neoplasm (CRN) recurrence according to the number of high-risk findings. METHODS: This was a retrospective and multicenter study. Patients who had one or more high-risk adenomas at the index colonoscopy and underwent follow-up colonoscopy 2.5 or more years after the index colonoscopy were included. The number of high-risk findings was defined as follows: number of adenomas larger than 1 cm + number of adenomas with HGD + number of adenomas with a villous component + existence (counted as 1) or nonexistence (counted as 0) of three or more adenomas. RESULTS: A total of 1646 patients were included, and the mean duration between index and follow-up colonoscopy was approximately 4 years. The cumulative incidence rate of recurrent advanced CRN in patients with three or more high-risk findings was higher than that in patients with one or two high-risk findings (p < 0.001). However, the difference in 3-year cumulative incidence rates of recurrent advanced CRN between the two groups was not great, although it was statistically significant (4.8 vs. 2.3 %, p = 0.039). CONCLUSIONS: A 3-year surveillance interval for patients with multiple high-risk findings, regardless of the number of high-risk findings, appears reasonable.
BACKGROUND: Data regarding outcomes for patients with multiple findings for high-risk adenomas are scarce. AIM: To compare the risk for colorectal neoplasm (CRN) recurrence according to the number of high-risk findings. METHODS: This was a retrospective and multicenter study. Patients who had one or more high-risk adenomas at the index colonoscopy and underwent follow-up colonoscopy 2.5 or more years after the index colonoscopy were included. The number of high-risk findings was defined as follows: number of adenomas larger than 1 cm + number of adenomas with HGD + number of adenomas with a villous component + existence (counted as 1) or nonexistence (counted as 0) of three or more adenomas. RESULTS: A total of 1646 patients were included, and the mean duration between index and follow-up colonoscopy was approximately 4 years. The cumulative incidence rate of recurrent advanced CRN in patients with three or more high-risk findings was higher than that in patients with one or two high-risk findings (p < 0.001). However, the difference in 3-year cumulative incidence rates of recurrent advanced CRN between the two groups was not great, although it was statistically significant (4.8 vs. 2.3 %, p = 0.039). CONCLUSIONS: A 3-year surveillance interval for patients with multiple high-risk findings, regardless of the number of high-risk findings, appears reasonable.
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