Pathologic Features of Initial Adenomas as Predictors for Metachronous Adenomas of the Rectum
Gong Yang,Wei Zheng,Qi Rong Sun,Xiao-Ou Shu,Wei Dong Li,Hai Yu,Gao Fei Shen,Yong Zhou Shen,John D. Potter,Shu Zheng +9 more
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TLDR
The risk of metachronous adenomas is closely related to the pathology of initial adenomatous polyps, thus allowing identification of a high-risk group of adenoma patients for close surveillance after their initial polypectomy.Abstract:
Background Colorectal cancer is the third most common cancer in the world, arising mostly from pre-existing adenomatous polyps (adenomas) of the large bowel. Patients with colorectal adenomas are at increased risk of colorectal cancer because of a high recurrence rate for adenomas. We followed a cohort of 1490 patients with rectal adenomas to determine whether recurrence might be related to pathologic characteristics of the initial adenomas. Methods The patients were identified in Haining County, China, from 1977 through 1978 by means of examination with a 15-cm rigid sigmoidoscope. They were followed by endoscopic examination at years 2, 4, 6, 11, and 16 after their initial polypectomy. New adenomas in the rectum were identified in 280 patients in these follow-up examinations. Results Statistically significant twofold to threefold elevated risks of metachronous (recurrent) adenomas were observed for patients who had more than two initial adenomas or whose most advanced initial adenoma was more than 1.0 cm in size, was of villous/tubulovillous type, or showed moderate to severe dysplasia. Much stronger associations were observed for advanced metachronous neoplasms, which are defined as cancers or adenomas with severe dysplasia, with multivariate adjusted relative risks (95% confidence interval) of 4.2 (1.8-9.9) for a large initial adenoma (>1.0 cm), 8.1 (4.2-15.6) for villous/tubulovillous architecture, and 14.4 (5.0-41.3) for severe dysplasia. In particular, patients who had a large (>1.0 cm) adenoma with severe dysplasia at baseline had a relative risk of 37 (7.8-174.7) of developing advanced metachronous neoplasms compared with patients who had small adenoma(s) with mild dysplasia. Conclusions The risk of metachronous adenomas is closely related to the pathology of initial adenomas, thus allowing identification of a high-risk group of adenoma patients for close surveillance after their initial polypectomy.read more
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The Risk of Metachronous Advanced Colorectal Neoplasia Rises in Parallel with an Increasing Number of High-Risk Findings at Baseline.
TL;DR: The presence of overlapping multiple high-risk findings was associated with an increased risk of advanced neoplasia during surveillance in patients who underwent removal of colorectal adenomas between 2005 and 2009.
PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND HEPATOLOGY Prevention of Interval Colorectal Cancers: What Every Clinician Needs to Know
Swati G. Patel,Dennis J. Ahnen +1 more
TL;DR: There are a variety of strategies to decrease interval CRC rates including use of a split-dosed bowel preparation, optimizing withdrawal technique, ensuring complete polypectomy, and careful pathologic examination of the tissue removed as discussed by the authors.
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Prognostic assay for metachronous colorectal cancer
TL;DR: In this article, the average longest nuclear axis for a set of elongate nuclei in elongate cells in dysplastic tissue within a colorectal mucosa tissue sample was determined.
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Development of colorectal advanced neoplasia/adenomas in the long-term follow-up of patients submitted to colonoscopy with polipectomy
Renata Andreoli Rostirolla,Julio C. Pereira-Lima,Claudio Rolim Teixeira,Aline Weyne Schuch,Camila Perazzoli,Carlos Saul +5 more
TL;DR: Patients with advanced neoplasia at index colonoscopy presented with a higher probability of harbouring this condition during the follow-up when compared with other two groups, and lesions also occur earlier in this patients than in the ones without these lesions at the first examination.
Journal ArticleDOI
Displasia de alto grado como factor de riesgo de neoplasia colorrectal avanzada metacrónica, en pacientes con adenomas avanzados
Antonio Z. Gimeno-García,Francisco Ramírez,Victoria Gonzalo,Francesc Balaguer,Anna Petit,Maria Pellise,Josep Llach,Josep M. Bordas,Josep M. Piqué,Antoni Castells +9 more
TL;DR: La DAG no supone un riesgo adicional para el desarrollo of CCR ni AA metacronico en los pacientes con AA, y no seria necesario modificar el intervalo de seguimiento propuesto para el conjunto de los AA.
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