Sessile serrated adenomas: high-risk lesions?

Area of Science:

• Gastroenterology
• Colorectal Cancer Screening
• Pathology

Background:

• Sessile serrated adenomas (SSAs) were not widely recognized until around 2005.
• Early diagnosis and follow-up are crucial for managing SSAs.
• This study evaluates long-term outcomes of SSAs diagnosed between 2002-2004.

Purpose of the Study:

• To evaluate the follow-up of patients diagnosed with SSAs.
• To compare SSA follow-up with that of sporadic tubular adenomas.
• To determine appropriate surveillance guidelines for SSAs.

Main Methods:

• Retrospective review of 99 SSAs from 93 patients (2002-2004).
• Comparison with a control group of 92 patients with sporadic tubular adenomas.
• Analysis of follow-up colonoscopy findings and outcomes.

Main Results:

• 46.2% of SSA patients had follow-up; 97.6% had new lesions detected.
• 1 patient (2.3%) developed mucinous adenocarcinoma; 1 (2.3%) had high-grade dysplasia.
• SSA patients had higher recurrence rates (51.2%) than tubular adenoma patients (3.0%).

Conclusions:

• Rigorous follow-up for SSAs, akin to advanced adenomas, is warranted.
• Current surveillance for SSAs should be intensified.
• Clinical outcomes support managing SSAs as advanced adenomas.