![]() ![]() We gathered a total of 11,565 relevant cases that underwent colonoscopy between September of 1998 and August of 2007. 104-6993D), an extensive review of patient records was undertaken to gather relevant colonoscopy and pathology reports. We therefore conducted this retrospective cohort study with the primary goals of elucidating a general recurrence rate for advanced neoplasia in patients with HGD polyps at baseline screening, as well as the relationship between baseline endoscopic findings and risk of developing advanced neoplasia.Īfter obtaining approval from the Institutional Review Board of Keelung Chang Gung Memorial Hospital (IRB No. Indeed, only a few studies have yet to address the long- term outcome of patients with HGD colon polyps following polypectomy. However, this finding was not duplicated in other studies. A univariate analysis using NCI Pooling Project data, adenomas with HGD were shown to be strongly associated with risk of advanced neoplasia by follow-up colonoscopy (OR, 1.77 95% CI, 1.41–2.22). Whether advanced adenoma (villous adenoma, severe dysplasia, and/or size ≥ 10 mm) at index colonoscopy exhibit more aggressive behavior and earlier recurrence than typical adenoma is still unclear. Specifically, location, size, histological type, presence of atypia, and number of adenomas detected at index colonoscopy are known risk factors for adenoma recurrence. The 5-year rate of recurrence for colonic adenoma following polypectomy range between 29–58%, and previous studies have suggested that adenoma traits at index colonoscopy are closely related to recurrence. The occurrence of CRC can also be effectively prevented by detecting and excising advanced adenomas, which are defined as larger than 10 mm, displaying a high grade dysplasia (HGD), and/or ≥ 20% villous. Polypectomy interrupts this sequence and reduces the incidence of CRC. CRCs originate from the initially benign colon adenomas that subsequently undergo an adenoma-carcinoma transition sequence. Risk of further developing advanced adenomas is associated with gender and the number of colon adenomas present.Ĭolorectal cancer (CRC) is the third leading cause of cancer-related death in Taiwan. Recurrence of colonic adenoma at time of follow-up colonoscopy is common in patients who undergo polypectomy for HGD colon adenomas during baseline colonoscopy. Multivariate analysis revealed gender (male) and adenoma count ≥ 3 at index colonoscopy to be significantly associated with recurrence of advanced adenoma. Univariate logistic regression analysis revealed that an adenoma count of ≥ 3 at baseline colonoscopy was strongly associated with overall recurrence, multiple recurrence, advanced recurrence, proximal recurrence, and distal adenoma recurrence with odds ratios of 4.32 (2.06–9.04 95% CI), 3.47 (1.67–7.22 95% CI), 2.55 (1.11–5.89 95% CI), 2.46 (1.16–5.22 95% CI), 2.89 (1.44–5.78 95% CI), respectively. ![]() Rates of metachronous adenoma and advanced adenoma at follow-up were 58% and 20%, respectively. Resultsĭata from 211 patients was included. Data from patients with HGD colon polyps who had undergone follow-up colonoscopy were included for analysis. Methodsġ1,565 patients at our facility underwent screen colonoscopy between September 1998 and August 2007. We conducted a clinical cohort study with patients who underwent polypectomy during screen colonoscopy to assess recurrent colonic adenoma risk factors. The risk of recurrent colonic adenoma associated with high-grade dysplasia (HGD) colon polyps at baseline colonoscopy remains unclear. ![]()
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