Colorectal Adenoma Characteristics as Predictors of Recurrence

Abstract

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.

Clinical and endoscopic predictors of colorectal adenoma recurrence after colon polypectomy

“…Some studies have found that a proximal colon location indicates a high risk of recurrence (15). However, some of the above findings have not been borne out by larger studies.…”

Association Between Body Size and Colorectal Adenoma Recurrence

“…Among patients that have had colorectal adenomas, recognized predictors of subsequent lesions include age, adenoma size, histology and multiplicity of the lesions at detection 1 . Depending on the age of the population, between 20 and 50% of those patients with adenomas will recur within a 3-5 year period, with 10-20% of recurrent lesions possessing clinically advanced features (larger size, villous histology, and/or high-grade dysplasia) [2][3][4][5][6] . The current recommendation for patients presenting with small polyps (less than 1 cm) is to have a followup colonoscopy 5-10 years after the initial procedure 1 .…”

Microtubular Colorectal Adenoma an Aggressive Histologic Phenotype with Propensity to Evolve into Invasive Carcinoma

“…It should be pointed out, however, that the definition of ACRC varies in the literature. Some authors regard as ACRC those adenomas measuring >1cm in diameter [20,21], others >1cm in diameter with villous histology [22][23][24]; others require the presence of HGD [25][26][27]; others, at least 1 cm or with villous elements at a frequency greater than 20% or with HGD [28]; and others as carcinoma in situ (intraepithelial carcinoma, IEC) [29][30][31]. Finally, some authors require the presence of in tramucosal carcinoma (IMC) [19,[32][33][34].…”