The identification of groups with a high risk of colorectal adenoma recurrence remains difficult.
In this study, researchers from Europe assessed the predictive value of initial patient and adenoma characteristics on recurrence.
The team assessed 552 patients with resected colorectal adenomas from the European Fiber-Calcium Intervention trial.
|Number of adenomas and their proximal location at baseline were the main predictors of recurrence.|
|Diseases of the Colon and Rectum|
They recorded the characteristics of any adenomas using standardized protocol. Characteristics were recorded at baseline and at 3 years.
The main outcomes measured by the team were the 3-year overall recurrence, recurrence of multiple and advanced adenomas, and proximal and distal recurrence.
The researchers observed a 3-year recurrence 22% of patients. More than 50% had recurrent adenomas on the proximal colon.
After adjustment, the team found that the number of adenomas and their proximal location at baseline were the main predictors of recurrence.
When compared with patients who had 1 or 2 adenomas on the distal colon, patients with ≥3 adenomas with at least one of these on the proximal colon had a greater risk of overall recurrence (5.3). These patients also had a greater risk of proximal recurrence (8.5), and advanced adenoma recurrence (5.5).
Dr Bonithon-Kopp's team concluded, "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 2 years in patients who have only 1 or 2 distal adenomas".