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 17 November 2017

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News

Surveillance of duodenal adenomas in familial adenomatous polyposis

The cumulative risk of patients with familial adenomatous polyposis developing stage IV duodenal polyposis is 43% at age 60 years, find researchers in the Journal of Clinical Oncology.

News image

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High-grade dysplasia on duodenal or jejunal adenomas and late-stage duodenal polyposis are major clinical events in patients with familial adenomatous polyposis (FAP).

In this study, researchers from France determined the frequency, risks, and cumulative risks of these events.

A total of 58 patients with FAP underwent endoscopic surveillance.
Spigelman’s score increased in 60% of patients.
Journal of Clinical Oncology

The team assessed the number, size, and histology of the duodenojejunal polyps. They also calculated a Spigelman’s score at each endoscopy.

The researchers found that during a median follow-up of 47.9 months, 35 patients with underwent 107 duodenojejunal examinations.

During this time the Spigelman’s score increased in 60% of patients, while high-grade dysplasia developed in 34%.

The team identified a high initial Spigelman’s score as a risk factor for high-grade dysplasia development.

The team also estimated the cumulative risk of developing stage IV duodenal polyposis. This was 43% at age 60 years and 50% at age 70 years. Dr Jean-Christophe Saurin's team concluded, "This…shows a higher duodenal polyposis progression rate and cumulative risk of late-stage (stage IV) duodenal polyposis in FAP patients compared with previous series".

"These results suggest that current modalities for surveillance and management of these patients need revision".

J Clin Oncol 2004; 22(3): 493-8
04 February 2004

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