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".