Risk of neoplastic change in large gastric hyperplastic polyps and recurrence after endoscopic resection.
Endoscopy
; 52(6): 444-453, 2020 06.
Article
em En
| MEDLINE
| ID: mdl-32120411
ABSTRACT
BACKGROUND:
Gastric hyperplastic polyps (GHPs) have a risk of neoplastic transformation reaching 5â%. Current endoscopic resection techniques appear suboptimal with a high risk of local recurrence. This study assessed the outcomes of endoscopic resection for GHPs and identified risk factors for recurrence and neoplastic transformation.METHODS:
This retrospective, multicenter, European study included adult patients with at least one GHP ≥â10âmm who underwent endoscopic resection and at least one follow-up endoscopy. Patients with recurrent GHPs or hereditary gastric polyposis were excluded. All data were retrieved from the endoscopy, pathology, and hospitalization reports.RESULTS:
From June 2007 to August 2018, 145 GHPs in 108 patients were included. Recurrence after endoscopic resection was 51.0â% (74â/145) in 55 patients. R0 resection or en bloc resection did not impact the risk of polyp recurrence. In multivariate analysis, cirrhosis was the only risk factor for recurrence (odds ratio [OR] 4.82, 95â% confidence interval [CI] 1.33â-â17.46; Pâ=â0.02). Overall, 15 GHPs (10.4â%) showed neoplastic transformation, with size >â25âmm (OR 10.24, 95â%CI 2.71â-â38.69; Pâ<â0.001) and presence of intestinal metaplasia (OR 5.93, 95â%CI 1.56â-â22.47; Pâ=â0.01) being associated with an increased risk of neoplastic transformation in multivariate analysis.CONCLUSIONS:
Results confirmed the risk of recurrence and neoplastic transformation of large GHPs. The risk of neoplastic change was significantly increased for lesions >â25âmm, with a risk of high grade dysplasia appearing in polyps ≥â50âmm. The risk of recurrence was high, particularly in cirrhosis patients, and long-term follow-up is recommended in such patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pólipos
/
Neoplasias Gástricas
/
Pólipos Adenomatosos
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
França