Risk of advanced lesions at the first follow-up colonoscopy after polypectomy of diminutive versus small adenomatous polyps of low-grade dysplasia

Orly Sneh Arbib, Valentina Zemser, Yaara Leibovici Weissman, Rachel Gingold-Belfer, Alex Vilkin, Sapir Eizenstein, Arnon Cohen, Doron Comaneshter, Shochat Tzipora, Yaron Niv, Yeuda Ringel, David Lieberman, Zohar Levi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background and Aims: The current guidelines for surveillance after polypectomy do not distinguish between diminutive (1-5 mm) and small (6-9 mm) polyps with low-grade dysplasia (LGD). We aimed to evaluate the risk for advanced neoplasia on follow-up colonoscopy. Methods: We retrospectively analyzed 443 patients whose worst finding at index colonoscopy was polypectomy of 1 to 5 or 6 to 9 mm polyps with LGD and those who underwent a follow-up colonoscopy. Results: During a mean follow-up of 32.0 months (interquartile range 13-48 months), advanced neoplasia was found in 26 patients (5.9%). Among all included patients (n = 443), advanced neoplasia was found in 13 of 310 patients (4.2%) of the 1- to 5-mm group versus 13 of 133 patients (9.8%) of the 6- to 9-mm group (hazard ratio [HR], 3.49; 95% confidence interval [CI], 1.6-7.6). Among the patients with 1 to 2 polyps resected (n = 313), advanced neoplasia was found in 8 of 231 patients (3.5%) of the 1- to 5-mm group versus 8 of 82 patients (9.8%) of the 6- to 9-mm group (HR 3.97; 95% CI, 1.47-10.7). Among the patients with ≥3 polyps resected (n = 130), advanced neoplasia was found in 5 of 79 patients (6.3%) of the 1- to 5-mm group versus 5 of 51 patients (9.8%) of the 6- to 9-mm group (HR 2.4; 95% CI, 0.7-8.36). Fair bowel preparation also was associated with the risk for advanced neoplasia at follow-up (HR 3.87, 95% CI, 1.70-8.82). Conclusions: Our findings suggest that among patients with up to 9-mm adenomatous polyps, a polyp size of 6 to 9 mm, >2 polyps, and fair bowel preparation are associated with advanced neoplasia.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
DOIs
StateAccepted/In press - Jun 30 2016

Fingerprint

Adenomatous Polyps
Colonoscopy
Polyps
Neoplasms
Confidence Intervals

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Risk of advanced lesions at the first follow-up colonoscopy after polypectomy of diminutive versus small adenomatous polyps of low-grade dysplasia. / Sneh Arbib, Orly; Zemser, Valentina; Leibovici Weissman, Yaara; Gingold-Belfer, Rachel; Vilkin, Alex; Eizenstein, Sapir; Cohen, Arnon; Comaneshter, Doron; Tzipora, Shochat; Niv, Yaron; Ringel, Yeuda; Lieberman, David; Levi, Zohar.

In: Gastrointestinal Endoscopy, 30.06.2016.

Research output: Contribution to journalArticle

Sneh Arbib, O, Zemser, V, Leibovici Weissman, Y, Gingold-Belfer, R, Vilkin, A, Eizenstein, S, Cohen, A, Comaneshter, D, Tzipora, S, Niv, Y, Ringel, Y, Lieberman, D & Levi, Z 2016, 'Risk of advanced lesions at the first follow-up colonoscopy after polypectomy of diminutive versus small adenomatous polyps of low-grade dysplasia', Gastrointestinal Endoscopy. https://doi.org/10.1016/j.gie.2017.02.034
Sneh Arbib, Orly ; Zemser, Valentina ; Leibovici Weissman, Yaara ; Gingold-Belfer, Rachel ; Vilkin, Alex ; Eizenstein, Sapir ; Cohen, Arnon ; Comaneshter, Doron ; Tzipora, Shochat ; Niv, Yaron ; Ringel, Yeuda ; Lieberman, David ; Levi, Zohar. / Risk of advanced lesions at the first follow-up colonoscopy after polypectomy of diminutive versus small adenomatous polyps of low-grade dysplasia. In: Gastrointestinal Endoscopy. 2016.
@article{2b88fb4eb79b4a3788f0efc0d0862d5b,
title = "Risk of advanced lesions at the first follow-up colonoscopy after polypectomy of diminutive versus small adenomatous polyps of low-grade dysplasia",
abstract = "Background and Aims: The current guidelines for surveillance after polypectomy do not distinguish between diminutive (1-5 mm) and small (6-9 mm) polyps with low-grade dysplasia (LGD). We aimed to evaluate the risk for advanced neoplasia on follow-up colonoscopy. Methods: We retrospectively analyzed 443 patients whose worst finding at index colonoscopy was polypectomy of 1 to 5 or 6 to 9 mm polyps with LGD and those who underwent a follow-up colonoscopy. Results: During a mean follow-up of 32.0 months (interquartile range 13-48 months), advanced neoplasia was found in 26 patients (5.9{\%}). Among all included patients (n = 443), advanced neoplasia was found in 13 of 310 patients (4.2{\%}) of the 1- to 5-mm group versus 13 of 133 patients (9.8{\%}) of the 6- to 9-mm group (hazard ratio [HR], 3.49; 95{\%} confidence interval [CI], 1.6-7.6). Among the patients with 1 to 2 polyps resected (n = 313), advanced neoplasia was found in 8 of 231 patients (3.5{\%}) of the 1- to 5-mm group versus 8 of 82 patients (9.8{\%}) of the 6- to 9-mm group (HR 3.97; 95{\%} CI, 1.47-10.7). Among the patients with ≥3 polyps resected (n = 130), advanced neoplasia was found in 5 of 79 patients (6.3{\%}) of the 1- to 5-mm group versus 5 of 51 patients (9.8{\%}) of the 6- to 9-mm group (HR 2.4; 95{\%} CI, 0.7-8.36). Fair bowel preparation also was associated with the risk for advanced neoplasia at follow-up (HR 3.87, 95{\%} CI, 1.70-8.82). Conclusions: Our findings suggest that among patients with up to 9-mm adenomatous polyps, a polyp size of 6 to 9 mm, >2 polyps, and fair bowel preparation are associated with advanced neoplasia.",
author = "{Sneh Arbib}, Orly and Valentina Zemser and {Leibovici Weissman}, Yaara and Rachel Gingold-Belfer and Alex Vilkin and Sapir Eizenstein and Arnon Cohen and Doron Comaneshter and Shochat Tzipora and Yaron Niv and Yeuda Ringel and David Lieberman and Zohar Levi",
year = "2016",
month = "6",
day = "30",
doi = "10.1016/j.gie.2017.02.034",
language = "English (US)",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Risk of advanced lesions at the first follow-up colonoscopy after polypectomy of diminutive versus small adenomatous polyps of low-grade dysplasia

AU - Sneh Arbib, Orly

AU - Zemser, Valentina

AU - Leibovici Weissman, Yaara

AU - Gingold-Belfer, Rachel

AU - Vilkin, Alex

AU - Eizenstein, Sapir

AU - Cohen, Arnon

AU - Comaneshter, Doron

AU - Tzipora, Shochat

AU - Niv, Yaron

AU - Ringel, Yeuda

AU - Lieberman, David

AU - Levi, Zohar

PY - 2016/6/30

Y1 - 2016/6/30

N2 - Background and Aims: The current guidelines for surveillance after polypectomy do not distinguish between diminutive (1-5 mm) and small (6-9 mm) polyps with low-grade dysplasia (LGD). We aimed to evaluate the risk for advanced neoplasia on follow-up colonoscopy. Methods: We retrospectively analyzed 443 patients whose worst finding at index colonoscopy was polypectomy of 1 to 5 or 6 to 9 mm polyps with LGD and those who underwent a follow-up colonoscopy. Results: During a mean follow-up of 32.0 months (interquartile range 13-48 months), advanced neoplasia was found in 26 patients (5.9%). Among all included patients (n = 443), advanced neoplasia was found in 13 of 310 patients (4.2%) of the 1- to 5-mm group versus 13 of 133 patients (9.8%) of the 6- to 9-mm group (hazard ratio [HR], 3.49; 95% confidence interval [CI], 1.6-7.6). Among the patients with 1 to 2 polyps resected (n = 313), advanced neoplasia was found in 8 of 231 patients (3.5%) of the 1- to 5-mm group versus 8 of 82 patients (9.8%) of the 6- to 9-mm group (HR 3.97; 95% CI, 1.47-10.7). Among the patients with ≥3 polyps resected (n = 130), advanced neoplasia was found in 5 of 79 patients (6.3%) of the 1- to 5-mm group versus 5 of 51 patients (9.8%) of the 6- to 9-mm group (HR 2.4; 95% CI, 0.7-8.36). Fair bowel preparation also was associated with the risk for advanced neoplasia at follow-up (HR 3.87, 95% CI, 1.70-8.82). Conclusions: Our findings suggest that among patients with up to 9-mm adenomatous polyps, a polyp size of 6 to 9 mm, >2 polyps, and fair bowel preparation are associated with advanced neoplasia.

AB - Background and Aims: The current guidelines for surveillance after polypectomy do not distinguish between diminutive (1-5 mm) and small (6-9 mm) polyps with low-grade dysplasia (LGD). We aimed to evaluate the risk for advanced neoplasia on follow-up colonoscopy. Methods: We retrospectively analyzed 443 patients whose worst finding at index colonoscopy was polypectomy of 1 to 5 or 6 to 9 mm polyps with LGD and those who underwent a follow-up colonoscopy. Results: During a mean follow-up of 32.0 months (interquartile range 13-48 months), advanced neoplasia was found in 26 patients (5.9%). Among all included patients (n = 443), advanced neoplasia was found in 13 of 310 patients (4.2%) of the 1- to 5-mm group versus 13 of 133 patients (9.8%) of the 6- to 9-mm group (hazard ratio [HR], 3.49; 95% confidence interval [CI], 1.6-7.6). Among the patients with 1 to 2 polyps resected (n = 313), advanced neoplasia was found in 8 of 231 patients (3.5%) of the 1- to 5-mm group versus 8 of 82 patients (9.8%) of the 6- to 9-mm group (HR 3.97; 95% CI, 1.47-10.7). Among the patients with ≥3 polyps resected (n = 130), advanced neoplasia was found in 5 of 79 patients (6.3%) of the 1- to 5-mm group versus 5 of 51 patients (9.8%) of the 6- to 9-mm group (HR 2.4; 95% CI, 0.7-8.36). Fair bowel preparation also was associated with the risk for advanced neoplasia at follow-up (HR 3.87, 95% CI, 1.70-8.82). Conclusions: Our findings suggest that among patients with up to 9-mm adenomatous polyps, a polyp size of 6 to 9 mm, >2 polyps, and fair bowel preparation are associated with advanced neoplasia.

UR - http://www.scopus.com/inward/record.url?scp=85017450307&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85017450307&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2017.02.034

DO - 10.1016/j.gie.2017.02.034

M3 - Article

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

ER -