TY - JOUR
T1 - Metachronous neoplasms in patients with laterally spreading tumours during surveillance
AU - Bogie, R.M.M.
AU - Winkens, B.
AU - Retra, S.J.J.
AU - le Clercq, C.M.C.
AU - Bouwens, M.W.
AU - Rondagh, E.J.A.
AU - Chang, L.C.
AU - de Ridder, R.
AU - Hoge, C.
AU - Straathof, J.W.
AU - Goudkade, D.
AU - Sanduleanu, S.
AU - Masclee, A.A.M.
N1 - Funding Information:
The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: RMMB, SSD and AAMM have received an educational grant from Pentax Medical BV. AAMM has received a ZonMw, The Netherlands Organization for Health Research and Development, healthcare efficiency grant to evaluate the efficacy of peppermint oil in irritable bowel syndrome (IBS). AAMM has received an unrestricted research grant from Will Pharma SA and received research funding from Allergan and Grünenthal on IBS topics. AAMM has given scientific advice to Bayer (topic: IBS) to Kyowa Kirin (topic: constipation) and to Takeda (topic: gastroparesis). SSD and AAMM have received funding from the Dutch Cancer Society related to endoscopy and to colorectal polyps.
Publisher Copyright:
© 2020 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology.
PY - 2021/4
Y1 - 2021/4
N2 - Background Laterally spreading tumours represent a major challenge for endoscopic detection and resection.Objective To examine synchronous and metachronous neoplasms in patients with laterally spreading tumours.Methods We prospectively collected colonoscopy and histopathology data from patients who underwent colonoscopy in our centre at up to 6 years' follow-up. Post-resection surveillance outcomes between laterally spreading tumours, flat colorectal neoplasms 10 mm or greater, and large polypoid colorectal neoplasms, polypoid colorectal neoplasms 10 mm or greater, were compared.Results Between 2008 and 2012, 8120 patients underwent colonoscopy for symptoms (84.6%), screening (6.7%) or surveillance (8.7%). At baseline, 151 patients had adenomatous laterally spreading tumours and 566 patients had adenomatous large polypoid colorectal neoplasms. Laterally spreading tumour patients had more synchronous colorectal neoplasms than large polypoid colorectal neoplasm patients (mean 3.34 vs. 2.34, p < 0.001). Laterally spreading tumour patients significantly more often developed metachronous colorectal neoplasms (71.6% vs. 54.2%, p = 0.0498) and colorectal neoplasms with high grade dysplasia/submucosal invasion than large polypoid colorectal neoplasm patients (36.4% vs. 15.8%, p < 0.001). After correction for age and gender, laterally spreading tumour patients were more likely than large polypoid colorectal neoplasm patients to develop a colorectal neoplasm with high grade dysplasia or submucosal invasion (hazard ratio 2.9, 95% confidence interval 1.8-4.6). The risk of metachronous colorectal cancer was not significantly different in laterally spreading tumours compared to large polypoid colorectal neoplasm patients.Conclusion Patients with laterally spreading tumours developed more metachronous colorectal neoplasms with high grade dysplasia/submucosal invasion than large polypoid colorectal neoplasm patients. Based on these findings endoscopic treatment and surveillance recommendations for patients with laterally spreading tumours should be optimised.
AB - Background Laterally spreading tumours represent a major challenge for endoscopic detection and resection.Objective To examine synchronous and metachronous neoplasms in patients with laterally spreading tumours.Methods We prospectively collected colonoscopy and histopathology data from patients who underwent colonoscopy in our centre at up to 6 years' follow-up. Post-resection surveillance outcomes between laterally spreading tumours, flat colorectal neoplasms 10 mm or greater, and large polypoid colorectal neoplasms, polypoid colorectal neoplasms 10 mm or greater, were compared.Results Between 2008 and 2012, 8120 patients underwent colonoscopy for symptoms (84.6%), screening (6.7%) or surveillance (8.7%). At baseline, 151 patients had adenomatous laterally spreading tumours and 566 patients had adenomatous large polypoid colorectal neoplasms. Laterally spreading tumour patients had more synchronous colorectal neoplasms than large polypoid colorectal neoplasm patients (mean 3.34 vs. 2.34, p < 0.001). Laterally spreading tumour patients significantly more often developed metachronous colorectal neoplasms (71.6% vs. 54.2%, p = 0.0498) and colorectal neoplasms with high grade dysplasia/submucosal invasion than large polypoid colorectal neoplasm patients (36.4% vs. 15.8%, p < 0.001). After correction for age and gender, laterally spreading tumour patients were more likely than large polypoid colorectal neoplasm patients to develop a colorectal neoplasm with high grade dysplasia or submucosal invasion (hazard ratio 2.9, 95% confidence interval 1.8-4.6). The risk of metachronous colorectal cancer was not significantly different in laterally spreading tumours compared to large polypoid colorectal neoplasm patients.Conclusion Patients with laterally spreading tumours developed more metachronous colorectal neoplasms with high grade dysplasia/submucosal invasion than large polypoid colorectal neoplasm patients. Based on these findings endoscopic treatment and surveillance recommendations for patients with laterally spreading tumours should be optimised.
KW - colorectal neoplasms
KW - laterallyspreadingtumours
KW - metachronousneoplasms
KW - non‐
KW - polypoidcolorectal neoplasms
KW - training
U2 - 10.1177/2050640620965317
DO - 10.1177/2050640620965317
M3 - Article
C2 - 33245025
SN - 2050-6406
VL - 9
SP - 378
EP - 387
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 3
ER -