Follow-up of Patients with Colorectal Adenomas

Matek, W; Guggenmoos-Holzmann, I.; Demling, L

doi:10.1055/s-2007-1018494

Cited by 107 publications

(49 citation statements)

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“…Some studies have been performed in patients with colorectal adenomas, an intermediary end point, examining the recurrence rate after polypectomy [37][38][39][40][41]. However, as malignant potential increases proportionately with polyp size [42,43], growth rate may be of greater importance.…”

Section: Introductionmentioning

confidence: 99%

Growth and Recurrence of Colorectal Polyps: A Double-Blind 3-Year Intervention with Calcium and Antioxidants

et al. 1998

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Background: Dietary calcium and antioxidants have been suggested as protective agents against colorectal cancer. This has been supported by animal experimental studies, case control and cohort studies. Materials and Methods: In a prospective intervention study of colorectal adenomas, and intermediary stage in colorectal carcinogenesis, 116 polyp-bearing patients received a placebo-controlled daily mixture of β-carotene 15 mg, vitamin C 150 mg, vitamin E 75 mg, selenium 101 µg, and calcium (1.6 g daily) as carbonate for a period of 3 years with annual colonoscopic follow-up to test if the mixture was able to reduce polyp growth or recurrence. All polyps of <10 mm at enrolment or follow-up were left unresected until the end of the study. Results: 87–91% of the patients attended the annual endoscopic follow-up investigations, and 19% of the patients dropped out of the medical intervention. The rest consumed 85% of the total amount of tablets over the 3 years. The fecal calcium concentration was 2.3–2.7 times higher in patients taking active medication compared to the placebo group. Diet registration showed that, when adding the intake of antioxidants and calcium from diet and intervention, there was a significant difference between the intake of these substances in the active and the placebo group. No difference was detected in the growth of adenomas between the active and the placebo group from year to year and for the total study period. Moreover, there was no effect on polyps of <5 or 5–9 mm, or on polyps in the different colonic segments analyzed separately. A reduced growth of adenomas was found in patients <60 years of age taking active medication (n = 8) compared to those taking placebo (n = 6; mean difference 2.3 mm; 95% CI 0.26–4.36). There was a significantly lower number of patients free of new adenomas in the placebo group compared to those taking active medication as tested by logistic regression and Kaplan-Meier analysis (log-rank test p value 0.035). Subgroup analysis showed that only the group of patients with no family history of colorectal cancer, those with only one adenoma at inclusion, and those <65 years benefitted from the intervention medication. Conclusion: The study did not find an overall effect on polyp growth. Our data, however, may support a protective role of calcium and antioxidants on new adenoma formation.

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Section: Introductionmentioning

confidence: 99%

Growth and Recurrence of Colorectal Polyps: A Double-Blind 3-Year Intervention with Calcium and Antioxidants

et al. 1998

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“…Hemen daima nonneoplastiktir. Villöz olan veya ağır displazi odağı içeren küçük poliplerin oranı %1'den azdır (19,20). Çalışmamızda ortalama polip boyutu 8 mm (2-70 mm) olarak saptandı.…”

Section: Discussionunclassified

Gastrointestinal poliplerin boyut, lokalizasyon ve histopatolojik tipleriyle değerlendirilmesi

Dölek¹,

Karabulut²,

Topal³

et al. 2015

Endoskopi Gastrointestinal

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Evaluation of gastrointestinal polyps according to their size, localization and histopathologic typesAmaç: Çalışmadaki amacımız merkezimizde tanı alan üst ve alt gastrointestinal sisteme ait polipektomi materyallerinin histopatolojik tipleri ile birlikte dökümante edilmesidir. Gereç ve Yöntem: Çalışmada Çankırı Devlet Hastanesi Patoloji Laboratuvarında 2011-2012 yılları arasında histopatolojik tanı verilen 271 adet gastrointestinal polip olgusu retrospektif olarak incelendi. Yerleşim özellikleri ve histopatolojik tiplerine göre polipler kaydedildi. Bulgular: Hastaların %69,4'ü erkek, %30,6'sı kadındı. Yaş dağılımı 2-91 yıl arasında değişmekte olup, yaş ortalaması 61,7 yıl, ortalama boyut 8 mm olarak saptandı. Gastrointestinal sistem polipleri yerleşim bölgeleri açısından değer-lendirildiğinde 271 olgunun 233'ü kolon, 38'i mide yerleşimliydi. Kolon yerleşimli poliplerin büyük kısmının rektumda (%36,2), mide yerleşimli poliplerin ise büyük kısmının antrumda (%6,3) oldukları saptandı. Gastrointestinal sistem poliplerinde histopatolojik tipler açısından en büyük hasta grubunu 161 (%59,4) olgu ile tübüler adenom oluştururken, bunu 63 (%23,2) olgu ile hiperplastik polipler takip etmekteydi. Kolondaki polipler erkeklerde daha sık görülürken, mide lokalizasyonlu polipler kadınlarda daha sık saptandı. Tartışma: Üst ve alt gastrointestinal sisteme ait polipleri ayrı ayrı değerlen-dirdiğimiz çalışmamızda genel olarak tüm sonuçlarımızın literatür ile uyumluluk halinde olduğu görüldü. Anahtar Kelimeler: Gastrointestinal polipler, histopatolojik tip, lokalizasyonBackground and Aims: We aimed to document upper and lower gastrointestinal system polyps in our center according to their types. Materials and Methods: 271 gastrointestinal polyps that were histopathologically diagnosed at Çankırı State Hospital during the period 2011-2012 were included in the study. Polyps were noted according to their localization and histopathologic types. Results: 69.4% of the patients were males and 30.6% were females, and their mean age was 61.7 years. The mean diameter of the polyps was 8 mm. 233 of the polyps were located in the colon and the remainder in the stomach. Colonic polyps were most commonly seen in the rectum (36.2%), while gastric polyps were most commonly seen in the antrum (6.3%). Colonic polyps were most common in males, while gastric polyps were most common in females. Conclusions: In this study, in which we evaluated upper and lower gastrointestinal polyps separately, our results were found to be similar to those reported in the literature.

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“…A rectosigmoidoscopic study of 1,000 polyps of up to 5 mm in size showed 86% to be neoplastic [23]. The likelihood of cancer existing in a polyp of less than 5 mm is < 0.1% for a 10-year period [24]. Approximately 5,000 adenomas measuring less than 6 mm when examined did not show any malignant changes [24,25].…”

Section: Discussionmentioning

confidence: 99%

Should We Perform Polypectomy for All Colorectal Polyps, or Follow-Up?

Öztürk¹,

Köklü²,

Basat³

et al. 2008

Chir Gastroenterol

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Background: There is controversy as to whether all colorectal polyps detected on colonoscopy should be removed. This study evaluated the histopathological characteristics of colorectal polyps in Turkish patients, and further determined their relationship to age, gender, size, and location. We aimed to determine the risk of neoplasms in patients with small polyps (≤5 mm), and emphasize the importance of polyp removal. Materials and Methods: Of 4,145 colonoscopies reviewed between July 2004 and June 2006, 791 polypectomies and 211 polyp biopsies were performed in 576 patients. Results: Of the 1,002 polyps histologically analyzed, 586 (58.5%) were non-neoplastic, and 396 (39.5%) were neoplastic. For the remaining 20 (2%), data are missing. Among the neoplastic polyps, 311 (78.5%) were tubular, 41 (10.4%) were tubulovillous, 31 (7.8%) were villous, and 13 (3.3%) showed a malignant transformation. 63% of the non-neoplastic polyps were hyperplastic, and the remaining 37% were inflammatory polyps. Both neoplastic and non-neoplastic polyps were located predominantly in the left colon (rectum, sigmoid, descending colon). Though only 31.7% of the polyps measuring <5 mm were neoplastic, 82.4% of the polyps >20 mm in size were neoplastic. There was no significant gender difference in distribution of either neoplastic or non-neoplastic polyps. The peak prevalence of both neoplastic and non-neoplastic polyps occurred in the 50–70-year age group. Conclusion: About half of the colorectal polyps are neoplastic in patients more than 50 years old. Even small polyps seen during colonoscopy should be removed and subjected to histological analysis. Western guidelines regarding colorectal polyps may also be applicable for the Turkish population.

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Follow-up of Patients with Colorectal Adenomas

Cited by 107 publications

References 0 publications

Growth and Recurrence of Colorectal Polyps: A Double-Blind 3-Year Intervention with Calcium and Antioxidants

Growth and Recurrence of Colorectal Polyps: A Double-Blind 3-Year Intervention with Calcium and Antioxidants

Gastrointestinal poliplerin boyut, lokalizasyon ve histopatolojik tipleriyle değerlendirilmesi

Should We Perform Polypectomy for All Colorectal Polyps, or Follow-Up?

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