Surveillance after colorectal polyp removal

Jover, Rodrigo; Dekker, Evelien

doi:10.1016/j.bpg.2016.10.005

Cited by 11 publications

(7 citation statements)

References 76 publications

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“…Post‐polypectomy surveillance is one of the leading indications of colonoscopy . Unfortunately, there is substantial evidence of its inappropriate use, with both overutilization and underutilization . In order to minimize such variability, international and national guidelines have been developed and are widely publicized among the endoscopic communities.…”

Section: Discussionmentioning

confidence: 99%

“…8,12 Unfortunately, there is substantial evidence of its inappropriate use, with both overutilization and underutilization. 8,13,14 In order to minimize such variability, international and national guidelines have been developed and are widely publicized among the endoscopic communities. According to such documents, appropriate surveillance indications may be given only after a high-quality baseline colonoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…Different guidelines on surveillance underscore the need for high‐quality baseline colonoscopy before appropriate follow‐up recommendations can be made . However, these guidelines do not specify the quality requisites that a baseline colonoscopy must fulfill . Although general quality of colonoscopy guidelines can be applied at index colonoscopy before indicating post‐polypectomy surveillance, there are some peculiarities of this indication not adequately addressed in this particular setting.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] However, these guidelines do not specify the quality requisites that a baseline colonoscopy must fulfill. 8 Although general quality of colonoscopy guidelines 9,10 can be applied at index colonoscopy before indicating post-polypectomy surveillance, there are some peculiarities of this indication not adequately addressed in this particular setting. This lack of guidance is particularly concerning when surveillance recommendations are made by clinicians who are not intimately familiar with colonoscopy quality standards.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Colonoscopy quality requisites for selecting surveillance intervals: A World Endoscopy Organization Delphi Recommendation

Jover

Dekker

Schoen

et al. 2018

Digestive Endoscopy

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Colonoscopy quality requisites for selecting surveillance intervals: A World Endoscopy Organization Delphi Recommendation

Jover

Dekker

Schoen

et al. 2018

Digestive Endoscopy

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“…Moreover, there is considerable variance in SSP detection rates and inconsistent pathological interpretation of these lesions [3]. As such, current surveillance guidelines for SPs vary substantially and are based on low quality evidence [4]. The purpose of this review is to provide a brief overview of SPs, particularly premalignant SPs such as SSPs and traditional serrated adenomas (TSAs), and discuss how recent epidemiological studies help inform current surveillance recommendations.…”

Section: Introductionmentioning

confidence: 99%

The Serrated Polyp Pathway: Is It Time to Alter Surveillance Guidelines?

O’Connell

Hafiz

Crockett

2017

Curr Gastroenterol Rep

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Purpose of the review In this manuscript, we review current surveillance guidelines for serrated polyps (SPs) and discuss how recent studies inform the selection of appropriate surveillance intervals for patients with SPs. Recent Findings Large and/or proximal SPs, particularly sessile serrated polyps (SSPs), are associated with increased risk of both synchronous and metachronous neoplasia, including advanced adenomas and colorectal cancer (CRC). Persons harboring multiple SSPs or dysplastic SSPs are at the highest risk. Moreover, a high percentage of large and/or proximal SPs are reclassified as SSPs when read by trained gastrointestinal pathologists, even if they were originally reported as hyperplastic polyps. These findings support the adoption of surveillance guidelines that prescribe closer surveillance of large and/or proximal SPs, regardless of subtype. Summary SSPs remain a challenge to reliably identify, resect, and diagnose via histology. The increased risk of future neoplasia in patients with SSPs is likely driven by a combination of underdetection, inadequate removal, misclassification, and biology. Until further evidence emerges, we support guidelines that recommend close surveillance of patients with a history of large and/or proximal SPs and SSPs specifically in order to mitigate the threat of interval CRC.

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Prediction of metachronous advanced colorectal neoplasia by KRAS mutation in polyps

Martínez‐Roca,

Cubiella,

García‐Heredia

et al. 2024

UEG Journal

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BackgroundThe potential of molecular markers in the removed polys as reliable predictors of metachronous lesions is still uncertain.AimOur aim was to evaluate the role of somatic mutations in KRAS in polyps of patients with high‐risk adenomas to predict the risk of advanced polyps or colorectal cancer (CRC) within 3 years.MethodsA total of 518 patients were prospectively enrolled. The included patients had adenomas ≥10 mm, high‐grade dysplasia, villous component or ≥3 more adenomas at baseline and were scheduled to undergo surveillance colonoscopy at 3 years ± 6 months. Somatic KRAS mutation was performed on 1189 polyps collected from these patients. At surveillance, advanced lesions were defined as adenomas with a size of ≥10 mm. High‐grade dysplasia or villous component, serrated polyps ≥10 mm or with dysplasia or CRC.ResultsAt baseline, 81 patients (15.6%) had KRAS mutations in at least one polyp. Patients with KRAS mutated polyps had more frequent villous histological lesions and size ≥20 mm. In the multivariate analysis, adjusted for age and sex, only age (odds ratios [OR], 1.06; 95% confidence interval [CI], 1.02–1.09; p < 0.001), ≥5 adenomas (OR, 3.92; 95% CI, 1.96–7.82), and KRAS mutation (OR, 2.54; 95% CI, 1.48–4.34; p < 0.01) were independently associated with the development of advanced lesions at surveillance.ConclusionsOur results show that, in patients with high‐risk adenomas, the presence of somatic mutations in KRAS is an independent risk factor for the development of advanced metachronous polyps.

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Surveillance after colorectal polyp removal

Cited by 11 publications

References 76 publications

Colonoscopy quality requisites for selecting surveillance intervals: A World Endoscopy Organization Delphi Recommendation

Colonoscopy quality requisites for selecting surveillance intervals: A World Endoscopy Organization Delphi Recommendation

The Serrated Polyp Pathway: Is It Time to Alter Surveillance Guidelines?

Prediction of metachronous advanced colorectal neoplasia by KRAS mutation in polyps

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