Evidence map›Paper›PMID 32472496›Full record

ArticleSurgical endoscopy2021

Recurrence with malignancy after endoscopic resection of large colon polyps with high-grade dysplasia: incidence and risk factors.

Neal Mehta, Ashraf Abushahin, Meena Sadaps, Mohammad Alomari, John Vargo, Deepa Patil, Rocio Lopez, Matthew Kalady, Conor P Delaney, Emre Gorgun and 4 more

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 20 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Colorectal Endoscopic Submucosal Dissection: An Update on Best Practice.Clinical and experimental gastroenterology · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 2 institutions in 2 countries.

Neal MehtaDepartment of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Desk A30, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. bhatta3@ccf.org.
Ashraf AbushahinDepartment of Internal Medicine, Medicine Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Meena SadapsDepartment of Hematology and Oncology, Cleveland Clinic, Cleveland, OH, USA.
Mohammad AlomariDepartment of Internal Medicine, Medicine Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
John VargoDepartment of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
Deepa PatilDepartment of Pathology, Cleveland Clinic, Cleveland, OH, USA.
Rocio LopezDepartment of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Matthew KaladyDepartment of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA.
Conor P DelaneyDepartment of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA.
Emre GorgunDepartment of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA.
James ChurchDepartment of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA.
Yutaka SaitoEndoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Carol A BurkeDepartment of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
Amit BhattDepartment of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
Cleveland Clinic · USNational Cancer Center Hospital East · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the West, piecemeal endoscopic resection remains the primary treatment for large colon polyps (LCP), as most recurrences are believed to be benign and resectable with follow-up endoscopy. However, invasive malignancy at the site of prior piecemeal endoscopic mucosal resection has been reported in the Asian literature. This study aims to identify the incidence of and the risk factors for local recurrence with malignancy after endoscopic resection of LCP with high-grade dysplasia (HGD).

methodsIn this retrospective cohort study, we identified patients undergoing complete endoscopic resection of LCPs (≥ 20 mm) with HGD at the Cleveland Clinic between January 2000 and December 2016. Demographic, endoscopic, and pathologic data were collected. All subsequent endoscopic and pathology reports were reviewed to identify recurrence. The cumulative incidence of malignancy at the polypectomy site was determined and univariate analysis was performed to assess risk factors.

resultsA total of 254 LCPs with HGD were resected in 229 patients. Mean polyp size was 29.2 mm. There were 138 lesions resected in piecemeal fashion and 116 en-bloc. After a median follow-up of 28.7 months for the entire cohort, local recurrence with malignancy was diagnosed in six cases. Median time to malignancy diagnosis was 28.5 months. All malignant cases occurred after piecemeal resection and none after en-bloc resection (HR 11.4; 95% CI 0.48-273).

conclusionMalignancy after endoscopic resection of LCPs with HGD is uncommon and may be associated with piecemeal resection. When possible, en-bloc resection should be the goal for the management of LCPs.

Indexed as

Colonic PolypsColorectal NeoplasmsEndoscopic Mucosal ResectionColonoscopyHumansIncidenceNeoplasm Recurrence, LocalRetrospective StudiesRisk FactorsColorectal malignancyEndoscopic resectionLarge colon polypLocal recurrence

Identifiers

PMID32472496
OpenAlexW3031277517

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.