New predictors of recurrence in post-polypectomy surveillance: A retrospective analysis of risk stratification for advanced adenomas and polyps

• Jun Zhang ^[2] ; You Deng ^[1] ; Hailing Tang ^[2] ; Jiaming Liu ^[2] ; Wangli Si ^[2] ; Baihe Sun ^[2] ; Kun Zhuang ^[2]
  1. [1] Capital Medical University

     Capital Medical University

     China

     
  2. [2] Xi’an Central Hospital. Xi’an, China
• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 117, Nº. 4, 2025, págs. 188-197
• Idioma: inglés
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• Resumen

  • Background and aims: 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. Methods: 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. Results: 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. Conclusions: 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.