Subtype-specific risk factors for gastric adenomas and independent predictors of recurrence after endoscopic...

Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma. The distinctions among subtypes of gastric adenomas have been infrequently explored in existing literature.

To assess the subtype-specific risk factors and outcomes of endoscopic resection (ER) for gastric adenomas.

This is a retrospective cohort study. Among 162 patients who underwent ER for gastric lesions larger than 10 mm between 2017 and 2022, 79 patients with gastric adenomas were included. Hyperplastic polyps (n = 37) and subepithelial lesions (n = 46) were excluded. Logistic regression and survival analyses were conducted.

The 79 patients (mean age 68.1 years; 65% male) had adenoma subtypes: 62% intestinal, 29% foveolar, 8% pyloric, and 1% oxyntic. The mean follow-up was 26 months. Intestinal adenoma was strongly linked to a family history of gastric adenocarcinoma and atrophic gastritis (P < 0.001); foveolar adenoma was significantly associated with intestinal metaplasia (P < 0.001). Pyloric adenomas had the largest polyp size (P < 0.001). Recurrence rates were 8%, 17%, and 17% for the respective subtypes (P = 0.07), with no significant difference in the meantime to recurrence (P = 0.8). Independent predictors of recurrence after ER included a family history of gastric adenocarcinoma, active Helicobacter pylori infection, polyp size ≥ 30 mm, presence of > 3 polyps and Paris 0-IIc morphology (P < 0.001).

This study identifies distinct risk factor profiles for different subtypes of gastric adenomas and independent recurrence predictors post-ER, underscoring the importance of subtype-specific tailored risk assessment and surveillance strategies.