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The Risk of Metachronous Advanced Colorectal Neoplasia Rises in Parallel with an Increasing Number of High-Risk Findings at Baseline.
Gut Liver. 2015 Nov 23; 9(6):741-9.GL

Abstract

BACKGROUND/AIMS

Colorectal adenomas that are ≥10 mm have villous histology or high-grade dysplasia, or that are associated with ≥3 adenomas are considered high-risk for metachronous advanced neoplasia. We evaluated the cumulative incidence of metachronous advanced neoplasia according to the total number of high-risk findings detected on baseline colonoscopy.

METHODS

This was a retrospective cohort study performed in 862 patients who underwent removal of colorectal adenomas between 2005 and 2009. At least one surveillance colonoscopy had been conducted at Konkuk University Medical Center, Seoul, Korea.

RESULTS

The cumulative incidence of metachronous advanced neoplasia in patients with 0, 1, 2, and 3-4 high-risk findings at 1 year were 0.7%, 1.3%, 2.8%, and 8.0%; at 3 years, those were 5.9%, 11.9%, 15.5%, and 24.7%; and at 5 years, those were 8.5%, 18.7%, 26.3%, and 37.2%, respectively. In a multivariate model, the risk of metachronous advanced neoplasia was significantly higher for the multiple high-risk findings group when compared with the 0 high-risk findings group (1 high-risk (+) hazard ratio, 1.86 [95% confidence interval, 1.00-3.44]; 2 high-risk (+) 1.84 [0.88-3.84]; and 3-4 high-risk (+) 3.29 [1.54-7.01]; ptrend=0.020).

CONCLUSIONS

The presence of overlapping multiple high-risk findings was associated with an increased risk of advanced neoplasia during surveillance.

Links

Publisher Full Text
ncbi.nlm.nih.gov
gutnliver.org
PMC Free PDF

Authors+Show Affiliations

Lee SM
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Kim JH
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Sung IK
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Hong SN
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

MeSH

AdenomaAgedColonic PolypsColonoscopyColorectal NeoplasmsEarly Detection of CancerFemaleHumansIncidenceMaleMiddle AgedNeoplasm GradingNeoplasms, Second PrimaryPopulation SurveillanceProportional Hazards ModelsRepublic of KoreaRetrospective StudiesRisk FactorsTime FactorsTumor Burden

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25963078

Citation

Lee, Seung Min, et al. "The Risk of Metachronous Advanced Colorectal Neoplasia Rises in Parallel With an Increasing Number of High-Risk Findings at Baseline." Gut and Liver, vol. 9, no. 6, 2015, pp. 741-9.
Lee SM, Kim JH, Sung IK, et al. The Risk of Metachronous Advanced Colorectal Neoplasia Rises in Parallel with an Increasing Number of High-Risk Findings at Baseline. Gut Liver. 2015;9(6):741-9.
Lee, S. M., Kim, J. H., Sung, I. K., & Hong, S. N. (2015). The Risk of Metachronous Advanced Colorectal Neoplasia Rises in Parallel with an Increasing Number of High-Risk Findings at Baseline. Gut and Liver, 9(6), 741-9. https://doi.org/10.5009/gnl14210
Lee SM, et al. The Risk of Metachronous Advanced Colorectal Neoplasia Rises in Parallel With an Increasing Number of High-Risk Findings at Baseline. Gut Liver. 2015 Nov 23;9(6):741-9. PubMed PMID: 25963078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Risk of Metachronous Advanced Colorectal Neoplasia Rises in Parallel with an Increasing Number of High-Risk Findings at Baseline. AU - Lee,Seung Min, AU - Kim,Jeong Hwan, AU - Sung,In Kyung, AU - Hong,Sung Noh, PY - 2015/5/13/entrez PY - 2015/5/13/pubmed PY - 2016/8/17/medline KW - Colonoscopy KW - Colorectal neoplasia KW - Polypectomy KW - Surveillance SP - 741 EP - 9 JF - Gut and liver JO - Gut Liver VL - 9 IS - 6 N2 - BACKGROUND/AIMS: Colorectal adenomas that are ≥10 mm have villous histology or high-grade dysplasia, or that are associated with ≥3 adenomas are considered high-risk for metachronous advanced neoplasia. We evaluated the cumulative incidence of metachronous advanced neoplasia according to the total number of high-risk findings detected on baseline colonoscopy. METHODS: This was a retrospective cohort study performed in 862 patients who underwent removal of colorectal adenomas between 2005 and 2009. At least one surveillance colonoscopy had been conducted at Konkuk University Medical Center, Seoul, Korea. RESULTS: The cumulative incidence of metachronous advanced neoplasia in patients with 0, 1, 2, and 3-4 high-risk findings at 1 year were 0.7%, 1.3%, 2.8%, and 8.0%; at 3 years, those were 5.9%, 11.9%, 15.5%, and 24.7%; and at 5 years, those were 8.5%, 18.7%, 26.3%, and 37.2%, respectively. In a multivariate model, the risk of metachronous advanced neoplasia was significantly higher for the multiple high-risk findings group when compared with the 0 high-risk findings group (1 high-risk (+) hazard ratio, 1.86 [95% confidence interval, 1.00-3.44]; 2 high-risk (+) 1.84 [0.88-3.84]; and 3-4 high-risk (+) 3.29 [1.54-7.01]; ptrend=0.020). CONCLUSIONS: The presence of overlapping multiple high-risk findings was associated with an increased risk of advanced neoplasia during surveillance. SN - 2005-1212 UR - https://www.unboundmedicine.com/medline/citation/25963078/The_Risk_of_Metachronous_Advanced_Colorectal_Neoplasia_Rises_in_Parallel_with_an_Increasing_Number_of_High_Risk_Findings_at_Baseline_ L2 - http://www.gutnliver.org/journal/view.html?doi=10.5009/gnl14210 DB - PRIME DP - Unbound Medicine ER -