Serrated Polyposis Syndrome

Mankaney, Gautam; Rouphael, Carol; Burke, Carol A.

doi:10.1016/j.cgh.2019.09.006

Cited by 24 publications

(23 citation statements)

References 7 publications

(9 reference statements)

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“…The clearing phase is followed by endoscopic surveillance every 1 to 2 years. [4][5][6][7][8] Recent cohort studies have helped to develop evidencebased treatment and surveillance strategies. [4][5][6][7][8] However, most studies were retrospective, and the few prospective cohort studies were limited by a short follow-up duration.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7][8] Recent cohort studies have helped to develop evidencebased treatment and surveillance strategies. [4][5][6][7][8] However, most studies were retrospective, and the few prospective cohort studies were limited by a short follow-up duration. 5,[9][10][11] This has impeded analysis of the long-term risks (eg, CRC development, colonoscopy-related adverse events) of endoscopic surveillance after initial polyp clearance.…”

Section: Introductionmentioning

confidence: 99%

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The long-term outcomes and natural disease course of serrated polyposis syndrome: over 10 years of prospective follow-up in a specialized center

Bleijenberg

IJspeert

Hazewinkel

et al. 2020

Gastrointestinal Endoscopy

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Background and Aims: Serrated polyposis syndrome (SPS) is the most prevalent colonic polyposis syndrome known and is associated with a high risk of colorectal cancer (CRC) if left untreated. Treatment consists of clearance of the initial polyp burden, followed by lifelong stringent endoscopic surveillance. However, the long-term safety and efficacy of surveillance and the natural disease course after initial clearance have not been described in detail. Methods:We analyzed a single-center cohort of patients with SPS with over 10 years of prospective follow-up. Outcome measures were (1) CRC incidence, (2) postcolonoscopy adverse event rates, and (3) trends in polyp recurrence during endoscopic surveillance.Results: The cohort included 142 patients who underwent a median of 6 colonoscopies with a median of 47 months of prospective follow-up after initial polyp clearance. During surveillance (every 1-2 years), 1 case of CRC occurred (5-year CRC incidence, 1.0%; 95% confidence interval, 0%-2.9%). During 447 surveillance colonoscopies with 1308 polypectomies, 1 episode of postpolypectomy bleeding, 1 postpolypectomy syndrome, and no perforations occurred (adverse event rate, 0.45% per colonoscopy). During up to 9 rounds of surveillance, no upward or downward trend in polyp recurrence was observed. Conclusions:In this prospective cohort with over 10 years of follow-up, endoscopic surveillance was effective and safe, with a low risk of CRC and colonoscopy-related adverse events. Furthermore, we show that the disease course of SPS is such that the polyp burden remains more or less equal during long-term surveillance, which advocates lifelong adherence to (personalized) surveillance guidelines and discourages de-intensifying surveillance intervals after multiple rounds of surveillance. (Gastrointest Endosc 2020;92:1098-107.)

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The long-term outcomes and natural disease course of serrated polyposis syndrome: over 10 years of prospective follow-up in a specialized center

Bleijenberg

IJspeert

Hazewinkel

et al. 2020

Gastrointestinal Endoscopy

View full text Add to dashboard Cite

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“…Conversely, 1 potential gene that has been identified in SPS patients, RNF43, has been observed in a small percentage (<2%) of SPS patients, limiting its clinical utility. 3,4 In contrast to other polyposis syndromes that involve conventional adenomas or rare polyps such as hamartomas or juvenile polyps, SPS is diagnosed by the presence of multiple serrated polyps. Serrated polyps, detected in 1 in 5 screening patients, 5 are a heterogeneous group of polyps that include hyperplastic polyps, believed to have a benign course, and also traditional serrated adenomas (TSAs), which have dysplasia and sessile serrated polyps that can develop into dysplasia and subsequent CRC.…”

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confidence: 99%

“…In addition, the World Health Organization (WHO) definition of the criteria for this syndrome has been updated since the original definition was proposed, posing additional challenges for long-term outcome studies. 3 Thus, owing to lack of recognition and diagnosis of SPS, little is known about the longitudinal outcomes of patients with SPS, specifically as it pertains to endoscopic surveillance of these patients.…”

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confidence: 99%

“…WHO recommends that once the diagnosis is established, patients have a colonoscopy at 1-to 2-year intervals, depending on history and polyp burden. 3 Many experts suggest that the strategy may be divided into 2 phases: clearance and surveillance. 3,9,10 Although clearance phase intervals may be as short as 3 to 6 months, they can be lengthened to 1 to 2 years during the surveillance phase to maintain a low polyp burden.…”

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