The effect of small or diminutive adenomas at baseline colonoscopy on the risk of developing metachronous advanced colorectal neoplasia: KASID multicenter study |
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| Institution: | 1. Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea;2. Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea;3. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea;4. Department of Internal Medicine, Digestive Disease Research Institute, Wonkwang University College of Medicine, Iksan, Republic of Korea;5. Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine, Seoul, Republic of Korea;6. Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea;7. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea;8. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea;9. Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea;10. Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea;11. Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Republic of Korea;12. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea;13. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea |
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| Abstract: | BackgroundThe clinical significance of diminutive or small adenomas remains ill defined.AimsWe evaluated the clinical impact of diminutive or small adenomas at baseline on the risk of developing metachronous advanced colorectal neoplasia (CRN).MethodsThis multicenter, retrospective cohort study included 2252 patients with 1 or more colorectal adenomas at baseline and subsequent follow-up colonoscopy. Baseline colonoscopy findings were classified into 5 groups: 1 or 2 tubular adenomas (TAs) (<10 mm); 3–10 diminutive TAs (≤5 mm); 3–10 TAs, including 1 or 2 small adenomas (6–10 mm); 3–10 TAs, including 3 or more small adenomas; and advanced adenoma.ResultsIn multivariate analysis, after adjusting for possible confounding variables (age at baseline, sex, body mass index, smoking habits, family history of colorectal cancer, regular use of aspirin or NSAIDs, and adenoma location), 3–10 TAs including 3 or more small adenomas (hazard ratio HR] = 2.36, p = 0.034) and advanced adenoma (HR = 2.14, p < 0.001) were independent predictors for the risk of developing metachronous advanced CRN. However, 3–10 diminutive TAs or 3–10 TAs, including 1 or 2 small adenomas, were not associated with this outcome.ConclusionsMultiplicity of diminutive TAs, without advanced lesions, showed no clinical significance for risk of developing metachronous advanced CRN. |
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| Keywords: | Diminutive adenoma Metachronous colorectal neoplasia Small adenoma Surveillance |
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