New predictors of recurrence in post-polypectomy surveillance - A retrospective analysis of risk stratification for...

recent guidelines emphasized that not all patients with recurrent polyps benefit from post-polypectomy surveillance, except for advanced adenomas recurrence. This study aimed to analyze the recurrence risk factors for advanced adenomas and investigated the difference from any polyp recurrence.

this retrospective observational study included patients who underwent colonoscopy and at least one post-polypectomy surveillance. Multivariate regression models identified risk factors for the recurrence of polyps and advanced adenomas. The Youden index determined the optimal cut-off value for risk factors. Kaplan-Meier curve estimated the cumulative recurrence rates, and the log-rank tests compared the differences between these curves.

a total of 1,818 patients had polyps at baseline examination. During post-polypectomy surveillance, 1,063 patients had recurrent polyps, and 64 patients experienced recurrent advanced adenomas. Multivariate logistic analysis identified age as an independent risk factor for both advanced adenoma (OR [95 % CI]: 1.028 [1.003-1.056]) and polyps (OR [95 % CI]: 1.019 [1.009-1.028]), with cut-off values of 57 years and 53 years, respectively. A cut-off value of 40 years can increase the predictive sensitivity to 95 %. Polyps size (OR [95 % CI]: 1.070 [1.014-1.147]) and high-risk pathology (OR [95 % CI]: 6.339 [2.057-23.919]) were significantly associated with recurrence of advanced adenomas, but not with any polyps, with a size cut-off value of 7.5 mm. Except for high-risk pathology, neither hyperplastic polyps nor tubular adenomas with low-grade dysplasia increased the recurrence risk of advanced adenomas.

a cut-off value of 40 years can increase the predictive sensitivity to 95 % for both advanced adenomas and any polyps. Polyps size and high-risk pathology were associated with the recurrence of advanced adenoma, but not with any polyps.