Clinical and endoscopic predictors of colorectal adenoma recurrence after colon polypectomy

Turk J Gastroenterol. 2013;24(6):476-82. doi: 10.4318/tjg.2013.0610.

Abstract

Background/aims: Colonic adenoma is a well-known precancerous lesion of colon cancer. Therefore, the early detection of advanced colonic neoplasm is critical. This study aimed to determine whether findings at baseline colonoscopy are independent predictors of subsequent recurrence of adenoma in Korean patients.

Materials and methods: Patients who underwent complete colonoscopy ≥2 times at the Seoul Metropolitan Government-Seoul National University, Boramae Medical Center were included. Follow-up colonoscopy was done more than 1 year after removal. Colonoscopic findings at baseline examinations were compared for patients with and without adenoma recurrence.

Results: Of the 167 patients enrolled, 78 had recurrent adenoma at follow-up colonoscopy. Male patients had a higher risk of recurrence than female patients. Patients with ≥ 10 mm adenoma at baseline colonoscopy were more likely to have recurrent adenomas than those with < 10 mm adenoma. Patients with ≥4 adenoma at baseline colonoscopy had also an increased risk for recurrent adenomas. Multivariable analysis showed that ≥10 mm sized (Odds ratio 2.76, 95% confidence interval 1.07-7.11, p=0.035) and ≥4 adenomas (Odds ratio 2.58, 95% confidence interval 1.02-6.54, p=0.045) at baseline colonoscopy were independent predictors of adenoma recurrence at subsequent colonoscopy.

Conclusion: The presence of adenoma ≥10 mm or ≥4 adenomas at baseline colonoscopy were significant predictors of recurrent adenoma.

MeSH terms

  • Adenoma / pathology*
  • Adenoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Colonic Polyps / surgery*
  • Colonoscopy
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology*
  • Republic of Korea
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Tumor Burden*