Incidence of advanced adenomas at surveillance colonoscopy in patients with a personal history of colon adenomas: a meta-analysis and systematic review

Saini, Sameer D.; Kim, Hyungjin Myra; Schoenfeld, Philip

doi:10.1016/j.gie.2006.06.057

Cited by 174 publications

(158 citation statements)

References 28 publications

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“…No entanto, a prevalência geral de alterações colonoscópicas não variou entre os sexos, justificando a necessidade de realização de colonoscopias também entre as mulheres. Esses dados foram também confirmados por SAINI et al (17) que estudaram 1.463 mulheres e detectaram adenomas em 20,4% e neoplasia avançada em 4,9% dos casos.…”

Section: Discussionunclassified

Achados colonoscópicos em pessoas sem quadro clínico de doença colorretal

Petroianu

Alberti

Lima³

et al. 2009

Arq. Gastroenterol.

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RESUMO -Contexto -O câncer colorretal é causa de morte frequente e sua prevenção deve fazer parte dos programas de rastreamento em indivíduos assintomáticos. Objetivo -Avaliar os achados colonoscópicos de pessoas assintomáticas submetidas a colonoscopia. pólipos em 64,28%, doença diverticular em 27,92%, alterações inflamatórias em 9,74%, melanose colônica em 2,6% e angioectasias em 7,8%. Houve incidência maior de pólipos em indivíduos acima de 50 anos. A análise de regressão logística mostrou a idade e sexo como fatores preditores para a presença de pólipos (RR = 1,69; 1,23

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Section: Discussionunclassified

Achados colonoscópicos em pessoas sem quadro clínico de doença colorretal

Petroianu

Alberti

Lima³

et al. 2009

Arq. Gastroenterol.

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“…Patients who have undergone endoscopic resection of colorectal neoplasia generally receive a follow-up colonoscopy due to the increased risk of metachronous neoplasia (8). However, risk factors for the recurrence of colorectal neoplasia have yet to be fully elucidated.…”

Section: Elevated Risk Of Recurrent Colorectal Neoplasia With Helicobmentioning

confidence: 99%

Elevated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: A follow-up study of patients with endoscopically resected colorectal neoplasia

Inoue

Kato

Yoshimura

et al. 2012

Molecular and Clinical Oncology

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Abstract.In a previous population-based case-control study, we demonstrated an elevated risk of colorectal neoplasia with Helicobacter pylori (H. pylori) infection. The present study investigated the effects of H. pylori-associated chronic gastritis on the development of colorectal neoplasia by analyzing the recurrence of colorectal neoplasia subsequent to endoscopic resection. Ninety-nine patients who had undergone endoscopic resection of colorectal neoplasia were monitored under colonoscopy, and the recurrence of colorectal neoplasia was prospectively investigated. The stage of H. pylori-associated chronic gastritis in each subject was evaluated using a combination of two serum tests: H. pylori antibody and pepsinogen. In the present cohort, colorectal neoplasia recurred at a rate of 15,296/100,000 person-years during the study period. After adjusting for the confounding factors, chronic atrophic gastritis (CAG) was identified as an independent risk factor [adjusted hazard ratio (HR), 2.72; 95% confidence interval, 1.33-5.57], while H. pylori-infected non-atrophic gastritis was not identified as an independent risk factor for recurrent colorectal neoplasia. Colorectal neoplasia recurred earlier and was significantly more frequent in patients with CAG (22,573/100,000 person-years) compared to patients without CAG (11,089/100,000 person-years; P=0.029, log-rank test).Patients with more extensive CAG showed a higher risk of recurrence. These results demonstrated a significant elevation of the risk of recurrent colorectal neoplasia with the establishment and progression of CAG, indicating the involvement of H. pylori infection in the development of colorectal neoplasia. The two serum tests were useful clinical markers for noninvasively evaluating the risk of each individual for recurrent colorectal neoplasia subsequent to endoscopic resection.

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“…Presence of an isolated synchronous adenoma represents an independent risk factor for metachronicity, whereas having more than one adenoma increases the probability of developing metachronous lesions during follow-up. A higher trend towards metachronicity has been registered in patients with adenomatous resected polyps with no CRC, if these adenomas were larger (11,42), with vellous component (42), or with high grade dysplasia (11,43). Advanced adenomas share these three characteristics of being larger, with villous component and with high grade dysplasia.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to synchronous lesions, metachronic neoplasms will be adenomas in most cases and less frequently CRC. There are several publications related to development of metachronous lesions after the resection of the initial polyps in patients with adenomas, but without CRC (10)(11)(12)(13)(14). However, results obtained from these studies are frequently discordant variables depending on patients and adenomas features.…”

Section: Introductionmentioning

confidence: 99%

Drawing up an individual risk index for development of metachronous neoplastic lesions in resected colorectal cancer

Borda

Martínez-Peñuela²,

Borda

et al. 2012

Rev. esp. enferm. dig.

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Aim: to identify possible risk factors for the development of metachronous lesions in colorectal cancer (CRC) which would allow to establish a post-surgical individual prognostic index.Patients and methods: three hundred eighty-two surgically treated CRC were reviewed. We compared the incidence of metachronous lesions in 40 variables concerning patient clinical data and initial neoplastic findings. An individual risk index for metachronicity was drawn up including those variables which presented significant differences in multivariate logistic regression, dividing patients into three groups.Results: variables with prognostic value for metachronicity were distal cancer location: OR= 2.30 (1.03-5.13), alcohol intake: OR = 2.20 (1.08-4.48), presence of synchronous adenomas: isolated: OR = 2.47 (1.03-4.48), multiple: OR = 4.26 (1.78-10.17), and presence of synchronous advanced adenoma: OR= 2.91 (1.52-12.60). Tumor MUC-5 expression proved to have a protective role: ). An individual risk score was established considering these variables and patients could be classified into three groups, with a discrimination power for metachronicity of p< 0.0000001. Classification in high and low risk groups had a sensitivity = 75.32%, specificity = 84.21%, positive predictive value = 75.34%, negative predictive value = 92.31% and global diagnostic accuracy = 80.75%.Conclusions: the identification of risk factors for the development of metachronous lesions allow to calculate, at the time of surgical treatment, an individual prognostic index and to classify patients into three different risk groups. In high and low risk groups, both specificity and accuracy were acceptable for the prognosis of metachronous lesions, being remarkable the negative predictive power of our classification, which could become relevant when planning a different endoscopic follow up of these patients.Key words: Colorectal cancer. Follow-up. Metachronous lesions. INTRODUCTIONThe majority of colorectal cancers (CRC) are sporadic cases (1,2) and little is known about metachronous or synchronous neoplasms development (3,4). These multicentric lesions could be due to mutations in genes related to apoptosis, cellular proliferation or DNA repairing (5), or forms of hereditary non polyposis colorectal cancer syndrome with low penetrance (6). Finally, this tumor multicentricity could be caused by multiple interacting factors, such as personal or familial predisposition, environmental mechanisms, morphological or immunophenotypical tumor features which would favoured an increased risk of neoplasm development along different colonic sites (7). Once the tumor and all the possible synchronic lesions are endoscopically or surgically resected, the tumor multicentricity might promote the development of new neoplastic lesions (8,9). Similar to synchronous lesions, metachronic neoplasms will be adenomas in most cases and less frequently CRC. There are several publications related to development of metachronous lesions after the resection of the initial polyps in patient...

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Incidence of advanced adenomas at surveillance colonoscopy in patients with a personal history of colon adenomas: a meta-analysis and systematic review

Cited by 174 publications

References 28 publications

Achados colonoscópicos em pessoas sem quadro clínico de doença colorretal

Achados colonoscópicos em pessoas sem quadro clínico de doença colorretal

Elevated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: A follow-up study of patients with endoscopically resected colorectal neoplasia

Drawing up an individual risk index for development of metachronous neoplastic lesions in resected colorectal cancer

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