Utilize este identificador para referenciar este registo:
https://hdl.handle.net/1822/67213
Título: | Long-term follow-up after EMR of large colorectal lesions: metachronous lesions, predictors and surveillance timing |
Autor(es): | Costa, Dalila Amélia Amorim Brandão, Mariana Costa, Rita Gonçalves, Raquel Braga, A. C. Rolanda, Carla |
Palavras-chave: | Endoscopic Mucosal Resection Female Follow-Up Studies Humans Long Term Adverse Effects Male Middle Aged Neoplasm Recurrence, Local Neoplasm Staging Portugal Risk Factors Treatment Outcome Tumor Burden Colonoscopy Colorectal Neoplasms Neoplasms, Second Primary large coloretal adenomas long-term follow-up risk of metachronous lesions endoscopic surveillance |
Data: | Dez-2019 |
Editora: | Taylor and Francis |
Revista: | Scandinavian Journal of Gastroenterology |
Resumo(s): | Background: Endoscopic mucosal resection (EMR) is the first-line approach to large colorectal sessile lesions. These patients have been associated with high rates of metachronous lesions (ML), but long-term follow-up (LtFU) data are lacking. We aimed at evaluating the efficacy of an LtFU protocol and analyse the development and risk factors for ML.Methods: A prospectively collected database was analysed. Seventy-six patients submitted to EMR of large colorectal sessile lesions between 2007 and 2013 complied with a specific endoscopic surveillance, consisting of two protocols - initial follow-up (iFU) and LtFU. iFU intended to inspect the mucosectomy scars twice (at 3-6 and 12 months) and remove synchronous lesions (SL). Protocol examinations of LtFU were carried out at the first- and fourth-year post-iFU, aiming to remove ML. Statistical analysis included variables related to patient, index lesion, SL and ML characteristics.Results: Rates of ML were 39.5% and 20.4% at the first- and fourth-year of LtFU, and respectively 11.8% and 3.7% of them were advanced ML. All ML were endoscopically resectable. At univariate analysis, male gender (OR: 2.91; p=.029), the presence of SL (OR 3.86, p=.010) and advanced SL (OR 4.25, p=.006) were risk factors for ML. At multivariate analysis, male gender (p=.031) and advanced SL (p=.006) were significant predictors of ML development.Conclusions: We confirmed the increased risk of ML in patients with large colorectal lesions. A significant number of advanced ML was removed at the first LtFU colonoscopy, probably it should be carried out earlier than currently recommended. |
Tipo: | Artigo |
URI: | https://hdl.handle.net/1822/67213 |
DOI: | 10.1080/00365521.2019.1694066 |
ISSN: | 0036-5521 |
e-ISSN: | 1502-7708 |
Arbitragem científica: | yes |
Acesso: | Acesso restrito autor |
Aparece nas coleções: | ICVS - Artigos em revistas internacionais / Papers in international journals |
Ficheiros deste registo:
Ficheiro | Descrição | Tamanho | Formato | |
---|---|---|---|---|
costa2019.pdf Acesso restrito! | 1,11 MB | Adobe PDF | Ver/Abrir |