Endoscopic surveillance in patients with multiple (10-100) colorectal polyps
Por:
Valentin, F, Guarinos C, Juarez M, Rodriguez M, Serradesanferm, A, Rodri-guez-Moranta, F, Nicolas-Perez, D, Bujanda L, Herraiz, M, De-Castro, L, Fernandez-Banares, F, Herreros-de-Tejada, A, Martinez, F, Aguirre, E, Ferrandez, A, Diaz-Tasende, J, Pinol, V, Paya A, Egoavil C, Alenda C, Castells, A, Jover R and Cubiella, J
Publicada:
1 ene 2016
Categoría:
Gastroenterology
Resumen:
Background and study aims: Endoscopic surveillance in patients with multiple colorectal polyps aims to reduce colorectal cancer (CRC) incidence and mortality, as well as the need for colorectal surgery. The aim of this study was to determine the risk of developing CRC or the need for surgery during endoscopic surveillance in a cohort of patients with multiple (10-100) colorectal polyps.
Patients and methods: This was a multicentrer, longitudinal, observational study in 15 CRC high risk clinics in Spain, carried out between January 2009 and December 2010. Patients who were included in the EPIPOLIP trial and had at least 1 year of follow-up were included in the study. The primary outcome of interest was the incidence of CRC at least 1 year following the initial colonoscopy. The secondary outcome was the need for colorectal surgery.
Results: A total of 265 patients were followed for a median of 3.8 years. Patients underwent a median of 5 colonoscopies, and 17 patients (6.4 %) were diagnosed with CRC. A total of 32 patients (12.1 %) underwent surgery, including 15 (5.7 %) for prophylaxis without a diagnosis of CRC. The corresponding incidence density rates for CRC and colorectal surgery were 1.4 (95% confidence interval [CI] 0.7 to 2.1) and 2.7 (95 % CI 1.7 to 3.6) per 100 patient-years, respectively. Only the presence of symptoms at first colonoscopy was independently associated with CRC diagnosis (hazard ratio [HR] 7.7, 95% CI 1.1 to 59.3) and colorectal surgery (HR 4.6, 95% CI 1.02 to 20.6).
Conclusions: Patients with more than 10 neoplastic polyps required frequent colonoscopies within a short follow-up period. More than 10% of patients required colorectal surgery within 4 years, more than half for incident CRC.
Filiaciones:
Valentin, F:
Univ Ourense, Dept Gastroenterol, Complexo Hosp, Orense 32005, Spain
Guarinos C:
Hosp Gen Univ Alicante, Unidad Invest, Alicante, Spain
Juarez M:
Hosp Gen Univ Alicante, Dept Gastroenterol, Alicante, Spain
Rodriguez M:
Hosp Gen Univ Alicante, Unidad Invest, Alicante, Spain
Serradesanferm, A:
Hosp Clin Barcelona, Unitat Avaluacio Suport Prevencio, Barcelona, Spain
Rodri-guez-Moranta, F:
Bellvitge Univ Hosp, Dept Gastroenterol, Barcelona, Spain
Nicolas-Perez, D:
Hosp Univ Canarias, Dept Gastroenterol, Tenerife, Spain
Bujanda L:
Univ Basque Country, UPV EHU, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Dept Gastroenterol Donostia Hospital Biodonostia, San Sebastian, Spain
Herraiz, M:
Univ Navarra Clin, Dept Gastroenterol, Pamplona, Spain
De-Castro, L:
Univ Vigo, Dept Gastroenterol, Complexo Hosp, Vigo 36310, Spain
Fernandez-Banares, F:
Hosp Univ Mutua Terrassa, Dept Gastroenterol, CIBERehd, Terrassa, Spain
Herreros-de-Tejada, A:
Hosp Univ Puerta De Hierro, Dept Gastroenterol, IDIPHIM, Madrid, Spain
Martinez, F:
Inst Valenciano Oncol, Dept Gastroenterol, Valencia, Spain
Aguirre, E:
Hosp Arnau Vilanova, Dept Oncol, Lleida, Spain
Ferrandez, A:
Univ Zaragoza, Serv Aparato Digest, Hosp Clin Univ, IIS Aragon, Zaragoza, Spain
Diaz-Tasende, J:
Hosp Univ 12 Octubre, Dept Gastroenterol, Madrid, Spain
Pinol, V:
Hosp Josep Trueta, Dept Gastroenterol, Girona, Spain
Paya A:
Hosp Gen Univ Alicante, Dept Pathol, Alicante, Spain
Egoavil C:
Hosp Gen Univ Alicante, Dept Pathol, Alicante, Spain
Alenda C:
Hosp Gen Univ Alicante, Dept Pathol, Alicante, Spain
Castells, A:
Univ Barcelona, IDI BAPS, Dept Gastroenterol, Hosp Clin,Ctr Invest Biomed Red Enfermedades Hepa, Barcelona, Spain
Jover R:
Hosp Gen Univ Alicante, Dept Gastroenterol, Alicante, Spain
Cubiella, J:
Univ Ourense, Dept Gastroenterol, Complexo Hosp, Orense 32005, Spain
|