Clinical characteristics of patients with serrated polyposis syndrome in Korea: comparison with Western patients

Abstract

Background/AimsSerrated polyposis syndrome (SPS) has been shown to increase the risk of colorectal cancer (CRC). However, little is known about the characteristics of Asian patients with SPS. This study aimed to identify the clinicopathological features and risk of CRC in Korean patients with SPS as well as the differences between Korean and Western patients based on a literature review.MethodsThis retrospective study included 30 patients with SPS as defined by World Health Organization classification treated at Samsung Medical Center, Korea, between March 1999 and May 2011.ResultsTwenty patients (67%) were male. The median patient age at diagnosis was 56 years (range, 39–76 years). A total of 702 polyps were identified during a median follow-up of 43 months (range, 0–149 months). Serrated polyps were noted more frequently in the distal colon (298/702, 55%). However, large serrated polyps and serrated adenomas were mainly distributed throughout the proximal colon (75% vs. 25% and 81% vs. 19%, respectively); 73.3% had synchronous adenomatous polyps. The incidence of CRC was 10% (3/30 patients), but no interval CRC was detected. A total of 87% of the patients underwent esophagogastroduodenoscopy and 19.2% had significant lesions.ConclusionsThe phenotype of SPS in Korean patients is different from that of Western patients. In Korean patients, SPS is more common in men, there were fewer total numbers of serrated adenoma/polyps, and the incidence of CRC was lower than that in Western patients. Korean patients tend to more frequently have abnormal gastric lesions. However, the prevalence of synchronous adenomatous polyps is high in both Western and Korean patients.

Feasibility and Safety of Endoscopic Control for Patients with Serrated Polyposis Syndrome

“…Knowledge of SPS epidemiology, genetic background, pathogenesis, and surveillance has improved in recent years. The patients involved in this study had a mean age of 63 years, and the ratio of males (42%) to females was not significantly different, which is consistent with previous reports [1–9, 13]. However, most patients (86%) only met criterion I of the WHO 2019 guidelines (≥5 SLs/polyps proximal to the rectum, all ≥5 mm in size, with ≥2 being ≥10 mm in size), which is higher than in Western countries.…”

“…On the other hand, the following factors may have favorably influenced our high EC rates. First, the proportion of CRC patients, which is estimated to range from 7.6% to 36.7% [1–9, 13], was relatively low (9%) in this study cohort, even when including prior CRC cases. Second, because of the higher rate of patients (86%) who only met criterion I of the WHO 2019 guidelines, the median total number of polyps resected per patient during the clearing phase was 10 (range: 5–40, IQR: 7–18), which is lower than reported by other studies [1–6, 8, 13].…”

“…Due to this increased risk of CRC, patients with SPS require total managementaccurate diagnosis, appropriate treatment, and surveillance. In recent years, several studies revealed new clinicopathological features of SPS [1][2][3][4][5][6][7][8][9][10][11][12][13], and the diagnostic criteria have been revised [14].…”

Synchronized early gastric cancer occurred in a patient with serrated polyposis syndrome: A case report

“…Hazewinkel et al [ 7 ] reported 9 of 105 SPS patients (8.6%) from five medical centers in Europe, which did not significantly differ from the expected number of the general population, but the cancer-specific risk was not estimated. A Korean study[ 8 ] reported the diagnosis of stomach cancer in 2 of 30 SPS patients (6.7%) via esophagogastroduodenoscopy, suggesting that Asian patients with SPS require screening of the upper gastrointestinal tract. The lack of data makes it difficult to determine whether patients with SPS are at increased risk of extracolonic cancers or whether these tumors were unrelated to SPS.…”

Serrated Polyposis Syndrome with a Synchronous Colon Adenocarcinoma Treated by an Endoscopic Mucosal Resection

“…One study reported that the prevalence of SPS was 0.06%, whereas the other study estimated the prevalence at 0.025%. 14,15 In western studies, the prevalence of SPS ranged from 0.08% to 0.66%. [16][17][18] The prevalence of SPS was reported to be 8.4% in Japan.…”