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DOI: 10.1055/s-0039-1681804
INCIDENCE AND RISK FACTORS FOR SESSILE SERRATED ADENOMAS AFTER CURATIVE SURGERY IN LEFT-SIDE COLON CANCER PATIENTS
Publikationsverlauf
Publikationsdatum:
18. März 2019 (online)
Aims:
Sessile serrated adenomas (SSAs) are known to be precursors of colorectal cancer (CRC). However, data regarding detection rates of premalignant lesions during colonoscopy surveillance in patients with a history of left-sided colonic resection for cancer are lacking. In this study, we aimed to identify the incidence and risk factors for serrated adenoma in left-side colorectal cancer patients.
Methods:
We retrospectively reviewed the medical records of patients who underwent left-sided colonic surgery for colon and rectal cancer at Chungnam national university hospital (CNUH) between September 2009 and September 2016. We enumerated the SSAs in patients with left-side colectomy who received 1 or more follow-up colonoscopies. The patients' baseline and SSA characteristics and colonoscopy information were reviewed.
Results:
A total of 539 patients were enrolled in the study. During the first follow-up, 98 SSAs were identified in 539 patients (22.2%). At the second follow-up, 51 SSAs were identified in 212 patients (24.0%). The mean age of the patients was 62.2 years and 77.0% patients were men. The mean first follow-up duration was 11.5 months, and the mean second follow-up duration was 25.8 months. Multivariate analysis showed that alcohol intake (HR, 1.603; 95% CI, 1.033 – 2.411), bowel preparation (HR, 0.599; 95% CI, 0.301 – 1.039), and the use of transparent cap (HR, 1.702; 95% CI, 1.060 – 2.735) were associated with serrated adenoma incidence in the first surveillance colonoscopy. However, in the second surveillance, the body mass index significantly increased the risk of SSAs (HR, 1.602; 95% CI, 1.060 – 2.836).
Conclusions:
Several lifestyle factors are associated with metachronous SSAs risk. The findings of this study enhance our understanding of the mechanisms of SSAs development and indicate that the risk of serrated pathway colorectal neoplasms could be reduced through lifestyle changes.
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