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High-risk metachronous polyps are more frequent in patients with traditional serrated adenomas than in patients with conventional adenomas: a multicenter prospective study

Title
High-risk metachronous polyps are more frequent in patients with traditional serrated adenomas than in patients with conventional adenomas: a multicenter prospective study
Author
은창수
Keywords
SOCIETY-TASK-FORCE; AMERICAN-CANCER-SOCIETY; ON-COLORECTAL-CANCER; COLONOSCOPY SURVEILLANCE; HYPERPLASTIC POLYPS; CONSENSUS UPDATE; NEOPLASIA PATHWAY; KRAS MUTATIONS; COLON POLYPS; GUIDELINES
Issue Date
2015-12
Publisher
MOSBY-ELSEVIER
Citation
GASTROINTESTINAL ENDOSCOPY, v. 82, NO 6, Page. 1087-1093
Abstract
Background and Aims: Although the malignant progression of serrated polyps has been clearly documented, the malignant potential of the traditional serrated adenoma (TSA) subtype has not been established. We compared the prevalence of metachronous polyps in surveillance colonoscopies between patients with TSA and those with conventional adenomas (CAs). Methods: Four hundred twenty patients were diagnosed with TSAs by current diagnostic criteria at 10 tertiary care university hospitals in Korea from January 2003 to December 2005; 186 patients who received surveillance colonoscopy after removal of initial polyps were enrolled. During the same time period, 372 age- and sex-matched patients diagnosed with CAs were used as a control group. Results: TSA patients had a significantly higher recurrence rate of colorectal polyps compared with CA patients (66.1% vs 43.5%, respectively). TSA patients had a greater number (3 vs 2) and larger size (8.6 +/- 5.7 vs 6.3 +/- 5.2 mm) of recurrent polyps compared with CA patients. TSA patients also had a higher rate of CA (54.8% vs 37.9%), serrated adenoma (14.0% vs. 0.8%), and hyperplastic polyp (33.3% vs. 13.7%) recurrence compared with CA patients. TSA patients had significantly greater odds of having a recurrent high-risk polyp than CA patients (odds ratio, 2.37; 95% confidence interval, 1.55-3.63). Conclusions: In comparison with patients with CAs, patients with TSAs have a higher metachronous occurrence rate of all polyp subtypes including CAs, serrated adenomas, and hyperplastic polyps. Moreover, the presence of TSAs is an independent predictor of a high-risk polyp occurrence.
URI
http://www.sciencedirect.com/science/article/pii/S0016510715024359?via%3Dihubhttp://hdl.handle.net/20.500.11754/29323
ISSN
0016-5107; 1097-6779
DOI
10.1016/j.gie.2015.05.016
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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