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Diseases of the Colon & Rectum
Published in: Diseases of the Colon & Rectum 3/2004

01-03-2004 | Original Contribution

Colorectal Adenoma Characteristics as Predictors of Recurrence

Published in: Diseases of the Colon & Rectum | Issue 3/2004

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PURPOSE

The identification of groups with a high risk of colorectal adenoma recurrence remains a controversial issue for clinicians. This study was designed to assess the predictive value of initial patient and adenoma characteristics of the three-year recurrence.

METHODS

The study population was composed of 552 patients with resected colorectal adenomas who completed the European Fiber-Calcium Intervention trial. At both baseline and three-year examinations, the characteristics of adenomas were recorded according to a standardized protocol. The main outcomes measured were the three-year overall recurrence, recurrence of multiple adenomas, recurrence of advanced adenomas (size ≥ 1 cm or tubulovillous/villous architecture or moderate/severe dysplasia), and proximal and distal recurrence.

RESULTS

A three-year recurrence was observed in 122 patients (22.1 percent), and more than one-half of them had recurrent adenomas on the proximal colon. After adjustment for patient characteristics and treatment allocation, the number of adenomas and their proximal location at baseline were the main predictors of recurrence. In comparison with patients who had one or two adenomas on the distal colon, patients with three or more adenomas with at least one of them located on the proximal colon had a much higher risk of overall recurrence (5.3; 95 percent confidence interval, 2.7–10.3), proximal recurrence (8.5; 95 percent confidence interval, 4.1–18), and advanced adenoma recurrence (5.5; 95 percent confidence interval, 2.4–12.6).

CONCLUSIONS

Follow-up colonoscopies in patients with adenomas should include careful examination of the proximal colon. The time interval between follow-up examinations could probably be extended beyond three years in patients who have only one or two distal adenomas.
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Metadata
Title
Colorectal Adenoma Characteristics as Predictors of Recurrence
Publication date
01-03-2004
Published in
Diseases of the Colon & Rectum / Issue 3/2004
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI
https://doi.org/10.1007/s10350-003-0054-1

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