PWE-039 Indicators of recurrence in complex colorectal polyps at resection. (June 2019)

• Record Type: Journal Article
• Authors: Hossain, Ejaz; Thayalasekaran, Sreedhari; Alkandari, Asma; Arndtz, Sophie; Abdelrahim, Mohamed; Bhandari, Pradeep
• Is Part Of: Gut. Volume 68(2019)Supplement 2
• Page Start: A190
• Page End: A191
• Publication Date: 2019-06
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2019-BSGAbstracts.363
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Cancer incidence in –0mm endoscopically detected colorectal lesions Introduction: Recent data has shown the risk of cancer in colorectal lesions <5mm is less than previously reported. This has lead to a 'resect and discard' strategy for diminutive polyps. Few studies have been done to demonstrate cancer incidence in lesions between –0 mm and formulating a treatment strategy for these lesions. Methods: We analysed outcomes of all patients who underwent colonoscopy from January 2007 to December 2018 and were found to have colorectal polyps. Data was prospectively collected on an online endoscopy reporting system and pathology reporting system. A chart review was then carried out analysing the site, size, morphology and histological diagnoses of each polyp. Results: A total of 15906 polyps were removed at colonoscopy over the specified period, size of the polyps ranging from 1 mm to 120 mm and a mean size of 7.3 mm. A histopathological diagnosis of 104 cancers was made (0.65% of all polyps), of which 94 cancers (90.25%) were associated with non pedunculated polyps [OR 1.45, 95%CI 0.7–.78]. 89 cancers were found in the left colon and rectum compared with 15 cancers in the right colon ( 85.5% vs 14.5%) [OR 4.31, 95%CI 2.–.7, p < 0.0001). Of the 2365 (14.87%) polyps –0mm in size, 4 (0.17%) had adenocarcinoma [OR 41.5, 95%CI 2.2–71, p=0.01] Conclusions: This study demonstrates that the prevalence of covert cancer in colorectal lesions between –0mm is very low. Cancer risk, however, increased more than 20 fold in polyps greater than 1 cm (3.6%) [OR 21, 95%CI 7.8–8.15 p<0.0001] Based on the above data, we can conclude that the 'resect and discard' strategy can be extended to colorectal lesions –0 mm in size.