CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(10): E1206-E1213
DOI: 10.1055/a-2341-9026
Original article

Colorectal tumor comorbidity is common in patients with duodenal tumors: Exploratory cross-sectional study

Mari Mizutani
1   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine Graduate School of Medicine, Tokyo, Japan (Ringgold ID: RIN38084)
,
2   Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine Graduate School of Medicine, Tokyo, Japan (Ringgold ID: RIN38084)
,
Kazuhiro Yamanoi
3   Department of Pathology, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Akiko Matsubara
4   Division of Diagnostic Pathology, Shiga University of Medical Science Hospital, Otsu, Japan (Ringgold ID: RIN469340)
,
Atsushi Nakayama
5   Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Kayoko Fukuhara
6   Center for Preventive Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Kentaro Iwata
7   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Kurato Miyazaki
7   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
5   Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Yoko Kubosawa
7   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Yukie Hayashi
8   Center for Preventive Medicine, Keio University School of Medicine Department of Internal Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN592818)
,
Yusaku Takatori
5   Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
5   Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Noriko Matsuura
5   Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Rieko Bessho
6   Center for Preventive Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Tomohisa Sujino
9   Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Kaoru Takabayashi
9   Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Hitoshi Ichikawa
6   Center for Preventive Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Kazuhiro Kashiwagi
6   Center for Preventive Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Hiromasa Takaishi
6   Center for Preventive Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Yasunori Sato
10   Department of Biostatistics, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Takanori Kanai
7   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
,
Ryoji Kushima
4   Division of Diagnostic Pathology, Shiga University of Medical Science Hospital, Otsu, Japan (Ringgold ID: RIN469340)
,
Naohisa Yahagi
5   Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan (Ringgold ID: RIN38084)
› Author Affiliations
Clinical Trial: Registration number (trial ID): UMIN000038749, Trial registry: UMIN Japan (http://www.umin.ac.jp/english/), Type of Study: Exploratory cross-sectional study

Abstract

Background and study aims The duodenum and colorectum are target organs for familial colorectal adenomatous polyposis, however, the association of duodenal epithelial tumors (DETs) and colorectal tumors is still controversial. The aim of our study was to elucidate the association between DET and colorectal tumor.

Patients and methods This was an exploratory cross-sectional study of patients with DETs treated by endoscopic resection at our hospital, between November 2018 and October 2022. Individuals who underwent colonoscopy as part of the health screening comprised the reference control group for comparison. In both groups, lesions suspected of being tumors were resected. The main outcome was the adenoma detection rate (ADR). Other outcomes were the detection rate for advanced neoplasia (AN) and risk factors for colorectal adenoma and AN, evaluated using univariate and multivariable analyses.

Results Analyses were based on data from 163 individuals in the DET group and 177 in the control group. ADR was higher in the DET (63.2%) than in the control (23.6%) group (P < 0.001). AN and invasive cancer rates were also significantly higher in the DET than in the control group (AN: 20.9% vs 3.4%, respectively, P < 0.001; invasive cancer: 3.1% vs 0%, respectively, P < 0.001). On logistic regression analysis, DET was found to be associated with a 5-fold increase in the detection rate of adenoma and 6-fold increase in AN detection.

Conclusions The study revealed significant association between DET and high ADR and a higher frequency of AN and invasive cancer. Screening colonoscopy is suggested for patients with DETs.



Publication History

Received: 05 December 2023

Accepted after revision: 05 June 2024

Accepted Manuscript online:
10 June 2024

Article published online:
28 October 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 
  • References

  • 1 Yahagi N, Kato M, Ochiai Y. et al. Outcomes of endoscopic resection for superficial duodenal epithelial neoplasia. Gastrointest Endosc 2018; 88: 676-682
  • 2 Yamasaki Y, Uedo N, Takeuchi Y. et al. Current status of endoscopic resection for superficial nonampullary duodenal epithelial tumors. Digestion 2018; 97: 45-51
  • 3 Serrano PE, Grant RC, Berk TC. et al. Progression and management of duodenal neoplasia in familial adenomatous polyposis: A cohort study. Ann Surg 2015; 261: 1138-1144
  • 4 Murray MA, Zimmerman MJ, Ee HC. Sporadic duodenal adenoma is associated with colorectal neoplasia. Gut 2004; 53: 261-265
  • 5 Ramsoekh D, van Leerdam ME, Dekker E. et al. Sporadic duodenal adenoma and the association with colorectal neoplasia: a case-control study. Am J Gastroenterol 2008; 103: 1505-1509
  • 6 Dariusz A, Jochen R. Increased prevalance of colorectal adenoma in patients with sporadic duodenal adenoma. Eur J Gastroenterol Hepatol 2009; 21: 816-818
  • 7 Pequin P, Manfredi S, Quentin V. et al. Patients with sporadic duodenal adenoma are a high-risk group for advanced colorectal neoplasia: results of a case-control study. Aliment Pharmacol Ther 2007; 26: 277-282
  • 8 Yamasaki Y, Kato M, Takeuchi Y. et al. Characteristics of synchronous and metachronous duodenal tumors and association with colorectal cancer: a supplementary analysis. J Gastroenterol 2023; 58: 459-469
  • 9 Fujimoto K, Fujishiro M, Kato M. et al. Guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment. Dig Endosc 2014; 26: 1-14
  • 10 Kato M, Uedo N, Hokimoto S. et al. Guidelines for Gastroenterological Endoscopy in Patients Undergoing Antithrombotic Treatment: 2017 Appendix on Anticoagulants Including Direct Oral Anticoagulants. Dig Endosc 2018; 30: 433-440
  • 11 Nagtegaal ID, Odze RD, Klimstra D. et al. The 2019 WHO classification of tumours of the digestive system. Histopathology 2020; 76: 182-188
  • 12 Dixon MF. Gastrointestinal epithelial neoplasia: Vienna revisited. Gut 2002; 51: 130-131
  • 13 Abbass R, Rigaux J, Al-Kawas FH. Nonampullary duodenal polyps: characteristics and endoscopic management. Gastrointest Endosc 2010; 71: 754-759
  • 14 Genta RM, Hurrell JM, Sonnenberg A. Duodenal adenomas coincide with colorectal neoplasia. Dig Dis Sci 2014; 59: 2249-2254
  • 15 Mangas-Sanjuan C, Seoane A, Alvarez-Gonzalez MA. et al. Factors associated with lesion detection in colonoscopy among different indications. United European Gastroenterol J 2022; 10: 1008-1019
  • 16 Jrebi NY, Hefty M, Jalouta T. et al. High-definition colonoscopy increases adenoma detection rate. Surg Endosc 2017; 31: 78-84
  • 17 Wei EK, Colditz GA, Giovannucci EL. et al. Cumulative risk of colon cancer up to age 70 years by risk factor status using data from the Nurses' Health Study. Am J Epidemiol 2009; 170: 863-872
  • 18 Roos E, Seppä K, Pietiläinen O. et al. Pairwise association of key lifestyle factors and risk of colorectal cancer: a prospective pooled multicohort study. Cancer Rep (Hoboken) 2022; 5: e1612
  • 19 Yabuuchi Y, Yoshida M, Kakushima N. et al. Risk factors for non-ampullary duodenal adenocarcinoma: a systematic review. Dig Dis 2022; 40: 147-155
  • 20 Saito Y, Oka S, Kawamura T. et al. Colonoscopy screening and surveillance guidelines. J Jpn Soc Gastrointest Endosc 2020; 62: 1519-1560
  • 21 Wolf AMD, Fontham ETH, Church TR. et al. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin 2018; 68: 250-281
  • 22 Guo CG, Ma W, Drew DA. et al. Aspirin use and risk of colorectal cancer among older adults. JAMA Oncol 2021; 7: 428-435
  • 23 Diallo A, Deschasaux M, Latino-Martel P. et al. Red and processed meat intake and cancer risk: Results from the prospective NutriNet-Santé cohort study. Int J Cancer 2018; 142: 230-237
  • 24 Giovannucci E, Rimm EB, Stampfer MJ. et al. A prospective study of cigarette smoking and risk of colorectal adenoma and colorectal cancer in U.S. men. J Natl Cancer Inst 1994; 86: 183-191