High yield of synchronous lesions in referred patients with large lateral spreading colorectal tumors

Benjamin L. Bick, Prasanna L. Ponugoti, Douglas Rex

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background and Aims: There are few data on the prevalence of synchronous colorectal lesions in patients who have large lateral spreading tumors (LLSTs). We sought to describe the rate of synchronous lesions found in patients who underwent endoscopic resection of large sessile adenomas and serrated lesions. Methods: This is a retrospective assessment of a prospectively created database of 728 consecutive patients with resected LLSTs who underwent complete clearing of the colon during 2 colonoscopies by a single expert endoscopist. Results: The 728 patients with resected LLSTs and complete clearing had 4578 synchronous lesions, including 584 patients (80.2%) with at least 1 synchronous conventional adenoma, 132 (18.1%) with at least 1 synchronous conventional adenoma ≥ 20 mm in size, 294 (40.4%) with at least 1 synchronous advanced conventional adenoma, and 6 patients with a synchronous lesion with cancer. Patients with an index large sessile conventional adenoma compared with those with an index large serrated lesion had on average more synchronous conventional adenomas (4.8 vs 2.9, . P = .001) and fewer synchronous serrated lesions (1.4 vs 4.5, . P < .001). Of the 97 patients with a serrated class index lesion, 28 (28.9%) met criteria for serrated polyposis. Conclusions: There is a very high prevalence of synchronous lesions, including other large and advanced synchronous lesions, in patients with flat or sessile conventional adenomas and serrated colorectal polyps. Patients with LLSTs in the colon need detailed clearing of the rest of the colon. Patients referred for endoscopic resection of serrated lesions ≥ 20 mm have a very high prevalence of serrated polyposis. This study has potential implications for further stratification of high-risk patient groups in postpolypectomy surveillance guidelines.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
DOIs
StateAccepted/In press - Jan 26 2016

Fingerprint

Colorectal Neoplasms
Adenoma
Colon
Neoplasms
Colonoscopy
Polyps
Databases
Guidelines

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

High yield of synchronous lesions in referred patients with large lateral spreading colorectal tumors. / Bick, Benjamin L.; Ponugoti, Prasanna L.; Rex, Douglas.

In: Gastrointestinal Endoscopy, 26.01.2016.

Research output: Contribution to journalArticle

@article{83c37414f28b452e9762201b2e1b1a7d,
title = "High yield of synchronous lesions in referred patients with large lateral spreading colorectal tumors",
abstract = "Background and Aims: There are few data on the prevalence of synchronous colorectal lesions in patients who have large lateral spreading tumors (LLSTs). We sought to describe the rate of synchronous lesions found in patients who underwent endoscopic resection of large sessile adenomas and serrated lesions. Methods: This is a retrospective assessment of a prospectively created database of 728 consecutive patients with resected LLSTs who underwent complete clearing of the colon during 2 colonoscopies by a single expert endoscopist. Results: The 728 patients with resected LLSTs and complete clearing had 4578 synchronous lesions, including 584 patients (80.2{\%}) with at least 1 synchronous conventional adenoma, 132 (18.1{\%}) with at least 1 synchronous conventional adenoma ≥ 20 mm in size, 294 (40.4{\%}) with at least 1 synchronous advanced conventional adenoma, and 6 patients with a synchronous lesion with cancer. Patients with an index large sessile conventional adenoma compared with those with an index large serrated lesion had on average more synchronous conventional adenomas (4.8 vs 2.9, . P = .001) and fewer synchronous serrated lesions (1.4 vs 4.5, . P < .001). Of the 97 patients with a serrated class index lesion, 28 (28.9{\%}) met criteria for serrated polyposis. Conclusions: There is a very high prevalence of synchronous lesions, including other large and advanced synchronous lesions, in patients with flat or sessile conventional adenomas and serrated colorectal polyps. Patients with LLSTs in the colon need detailed clearing of the rest of the colon. Patients referred for endoscopic resection of serrated lesions ≥ 20 mm have a very high prevalence of serrated polyposis. This study has potential implications for further stratification of high-risk patient groups in postpolypectomy surveillance guidelines.",
author = "Bick, {Benjamin L.} and Ponugoti, {Prasanna L.} and Douglas Rex",
year = "2016",
month = "1",
day = "26",
doi = "10.1016/j.gie.2016.06.035",
language = "English (US)",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - High yield of synchronous lesions in referred patients with large lateral spreading colorectal tumors

AU - Bick, Benjamin L.

AU - Ponugoti, Prasanna L.

AU - Rex, Douglas

PY - 2016/1/26

Y1 - 2016/1/26

N2 - Background and Aims: There are few data on the prevalence of synchronous colorectal lesions in patients who have large lateral spreading tumors (LLSTs). We sought to describe the rate of synchronous lesions found in patients who underwent endoscopic resection of large sessile adenomas and serrated lesions. Methods: This is a retrospective assessment of a prospectively created database of 728 consecutive patients with resected LLSTs who underwent complete clearing of the colon during 2 colonoscopies by a single expert endoscopist. Results: The 728 patients with resected LLSTs and complete clearing had 4578 synchronous lesions, including 584 patients (80.2%) with at least 1 synchronous conventional adenoma, 132 (18.1%) with at least 1 synchronous conventional adenoma ≥ 20 mm in size, 294 (40.4%) with at least 1 synchronous advanced conventional adenoma, and 6 patients with a synchronous lesion with cancer. Patients with an index large sessile conventional adenoma compared with those with an index large serrated lesion had on average more synchronous conventional adenomas (4.8 vs 2.9, . P = .001) and fewer synchronous serrated lesions (1.4 vs 4.5, . P < .001). Of the 97 patients with a serrated class index lesion, 28 (28.9%) met criteria for serrated polyposis. Conclusions: There is a very high prevalence of synchronous lesions, including other large and advanced synchronous lesions, in patients with flat or sessile conventional adenomas and serrated colorectal polyps. Patients with LLSTs in the colon need detailed clearing of the rest of the colon. Patients referred for endoscopic resection of serrated lesions ≥ 20 mm have a very high prevalence of serrated polyposis. This study has potential implications for further stratification of high-risk patient groups in postpolypectomy surveillance guidelines.

AB - Background and Aims: There are few data on the prevalence of synchronous colorectal lesions in patients who have large lateral spreading tumors (LLSTs). We sought to describe the rate of synchronous lesions found in patients who underwent endoscopic resection of large sessile adenomas and serrated lesions. Methods: This is a retrospective assessment of a prospectively created database of 728 consecutive patients with resected LLSTs who underwent complete clearing of the colon during 2 colonoscopies by a single expert endoscopist. Results: The 728 patients with resected LLSTs and complete clearing had 4578 synchronous lesions, including 584 patients (80.2%) with at least 1 synchronous conventional adenoma, 132 (18.1%) with at least 1 synchronous conventional adenoma ≥ 20 mm in size, 294 (40.4%) with at least 1 synchronous advanced conventional adenoma, and 6 patients with a synchronous lesion with cancer. Patients with an index large sessile conventional adenoma compared with those with an index large serrated lesion had on average more synchronous conventional adenomas (4.8 vs 2.9, . P = .001) and fewer synchronous serrated lesions (1.4 vs 4.5, . P < .001). Of the 97 patients with a serrated class index lesion, 28 (28.9%) met criteria for serrated polyposis. Conclusions: There is a very high prevalence of synchronous lesions, including other large and advanced synchronous lesions, in patients with flat or sessile conventional adenomas and serrated colorectal polyps. Patients with LLSTs in the colon need detailed clearing of the rest of the colon. Patients referred for endoscopic resection of serrated lesions ≥ 20 mm have a very high prevalence of serrated polyposis. This study has potential implications for further stratification of high-risk patient groups in postpolypectomy surveillance guidelines.

UR - http://www.scopus.com/inward/record.url?scp=84997241365&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84997241365&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2016.06.035

DO - 10.1016/j.gie.2016.06.035

M3 - Article

C2 - 27345133

AN - SCOPUS:84997241365

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

ER -