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Characteristics of rectosigmoid adenomas as predictors of synchronous advanced proximal colon neoplasms.
Am J Gastroenterol. 1996 Sep; 91(9):1809-13.AJ

Abstract

BACKGROUND/AIM

Colonoscopy is recommended to every patient with adenoma in rectosigmoid to disclose synchronous proximal neoplasms. The aim of this study was to determine whether characteristics of rectosigmoid adenomas are associated with proximal advanced neoplasms.

PATIENTS/METHODS

One hundred consecutive symptomatic patients who underwent total colonoscopy and had rectosigmoid adenomas were included in the study. Patients with iron-deficiency anemia were excluded. All polyps were removed endoscopically. An adenoma was considered advanced if it had a diameter > 1 cm and/or villous and/or severe dysplasia histology were present.

RESULTS

Advanced rectosigmoid adenomas were found in 55 of the 100 patients. Proximal neoplasms were found in 26 (26%) patients. In particular, nonadvanced adenomas were found in 15 (15%), advanced adenomas in eight (8%), and cancer in three (3%) patients. The presence of proximal neoplasms was related to neither sex, age, or presenting symptoms nor to any of the characteristics of rectosigmoid adenomas. On the contrary, the presence of advanced proximal neoplasms (advanced adenoma or cancer) was significantly correlated with the presence of advanced rectosigmoid adenomas, which were detected in 11 (20%) of the 55 patients with advanced and in none of the 45 patients with nonadvanced, rectosigmoid adenomas (odds ratio: 23.5, p = 0.001). Logistic regression analysis revealed that the presence of advanced rectosigmoid adenoma was the main predictor of advanced proximal neoplasms (beta: 1.34, p < 10(-6)).

CONCLUSIONS

Among patients with rectosigmoid adenomas, 1) proximal advanced neoplasms appear to exist only in those with advanced adenomas and 2) baseline colonoscopy does not seem necessary in those without advanced adenomas.

Authors+Show Affiliations

Papatheodoridis GV
Department of Gastroenterology, Tzaneion General Hospital of Piraeus, Greece.
Triantafyllou K
No affiliation info available
Tzouvala M
No affiliation info available
Paspatis G
No affiliation info available
Xourgias V
No affiliation info available
Karamanolis DG
No affiliation info available

MeSH

AdenomaAdenoma, VillousColonColon, SigmoidColonic NeoplasmsColonoscopyFemaleHumansLogistic ModelsMaleMiddle AgedNeoplasms, Multiple PrimaryPredictive Value of TestsRectal NeoplasmsRectumSigmoid Neoplasms

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8792703

Citation

Papatheodoridis, G V., et al. "Characteristics of Rectosigmoid Adenomas as Predictors of Synchronous Advanced Proximal Colon Neoplasms." The American Journal of Gastroenterology, vol. 91, no. 9, 1996, pp. 1809-13.
Papatheodoridis GV, Triantafyllou K, Tzouvala M, et al. Characteristics of rectosigmoid adenomas as predictors of synchronous advanced proximal colon neoplasms. Am J Gastroenterol. 1996;91(9):1809-13.
Papatheodoridis, G. V., Triantafyllou, K., Tzouvala, M., Paspatis, G., Xourgias, V., & Karamanolis, D. G. (1996). Characteristics of rectosigmoid adenomas as predictors of synchronous advanced proximal colon neoplasms. The American Journal of Gastroenterology, 91(9), 1809-13.
Papatheodoridis GV, et al. Characteristics of Rectosigmoid Adenomas as Predictors of Synchronous Advanced Proximal Colon Neoplasms. Am J Gastroenterol. 1996;91(9):1809-13. PubMed PMID: 8792703.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics of rectosigmoid adenomas as predictors of synchronous advanced proximal colon neoplasms. AU - Papatheodoridis,G V, AU - Triantafyllou,K, AU - Tzouvala,M, AU - Paspatis,G, AU - Xourgias,V, AU - Karamanolis,D G, PY - 1996/9/1/pubmed PY - 1996/9/1/medline PY - 1996/9/1/entrez SP - 1809 EP - 13 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 91 IS - 9 N2 - BACKGROUND/AIM: Colonoscopy is recommended to every patient with adenoma in rectosigmoid to disclose synchronous proximal neoplasms. The aim of this study was to determine whether characteristics of rectosigmoid adenomas are associated with proximal advanced neoplasms. PATIENTS/METHODS: One hundred consecutive symptomatic patients who underwent total colonoscopy and had rectosigmoid adenomas were included in the study. Patients with iron-deficiency anemia were excluded. All polyps were removed endoscopically. An adenoma was considered advanced if it had a diameter > 1 cm and/or villous and/or severe dysplasia histology were present. RESULTS: Advanced rectosigmoid adenomas were found in 55 of the 100 patients. Proximal neoplasms were found in 26 (26%) patients. In particular, nonadvanced adenomas were found in 15 (15%), advanced adenomas in eight (8%), and cancer in three (3%) patients. The presence of proximal neoplasms was related to neither sex, age, or presenting symptoms nor to any of the characteristics of rectosigmoid adenomas. On the contrary, the presence of advanced proximal neoplasms (advanced adenoma or cancer) was significantly correlated with the presence of advanced rectosigmoid adenomas, which were detected in 11 (20%) of the 55 patients with advanced and in none of the 45 patients with nonadvanced, rectosigmoid adenomas (odds ratio: 23.5, p = 0.001). Logistic regression analysis revealed that the presence of advanced rectosigmoid adenoma was the main predictor of advanced proximal neoplasms (beta: 1.34, p < 10(-6)). CONCLUSIONS: Among patients with rectosigmoid adenomas, 1) proximal advanced neoplasms appear to exist only in those with advanced adenomas and 2) baseline colonoscopy does not seem necessary in those without advanced adenomas. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/8792703/Characteristics_of_rectosigmoid_adenomas_as_predictors_of_synchronous_advanced_proximal_colon_neoplasms_ DB - PRIME DP - Unbound Medicine ER -