Pathologic Features of Initial Adenomas as Predictors for Metachronous Adenomas of the Rectum
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...Most of the studies that assessed risk factors for advanced adenomas at surveillance were either randomized controlled trials of surveillance,(25) chemoprevention trials, prospective surveillance studies,(24) or registry-based observational cohort studies of patients returning for surveillance with less structured follow up outside the context of a clinical trial.(7,12,21,30,31,33,35) The most consistent evidence for predicting subsequent advanced adenomas indicates that multiplicity, size, villous histology, and high-grade dysplasia are the important factors at baseline....
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...0 cm at baseline.(30) Noshirwani, et al....
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...4), respectively, for the development of subsequent advanced neoplasia (rectal cancer or severe dysplasia) in patients with moderate and severe dysplasia at baseline.(30) Lieberman, et al....
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...High-grade dysplasia is related to larger adenoma size and villous component at baseline and is an important predictor for subsequent advanced neoplasia in three of the observational cohort studies.(7,24,30) By definition, all adenomas have some level of dysplasia....
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...0) for the detection of advanced neoplasms (rectal cancer, or adenoma with severe dysplasia) at follow up.(30) Loeve reported a significant trend for increasing risk of colorectal cancer at surveillance in relationship to increasing villous component or carcinoma in situ compared with tubular histology....
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