Document Detail

Long-term follow-up after polypectomy treatment for adenoma-like dysplastic lesions in ulcerative colitis.
MedLine Citation:
PMID:  15224277     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: A previously published study by our group suggested that adenoma-like dysplasia-associated lesions or masses (DALMs) in ulcerative colitis (UC) may be treated adequately by polypectomy and continued endoscopic surveillance. The length of follow-up evaluation in these patients averaged only 42 months. The purpose of this study was to evaluate the long-term outcome of our previously defined group of UC patients, all with adenoma-like DALMs, who were treated by polypectomy. METHODS: The clinical, endoscopic, and pathologic outcome of 34 UC patients, 24 with an adenoma-like DALM, and 10 with a coincidental sporadic adenoma, 28 of whom were treated by polypectomy and continued endoscopic surveillance, and 6 by colonic resection, were compared with the outcome of 49 non-UC patients who were treated similarly for a sporadic adenoma. The mean length of follow-up evaluation averaged 82.1 months and 71.8 months for the 2 UC subgroups, respectively, and 60.4 months for the non-UC controls. RESULTS: Overall, 20 of 34 UC patients (58.8%) developed at least one further adenoma-like DALM on follow-up evaluation. One patient had flat low-grade dysplasia present in the colon, which was resected within 6 months of the initial polypectomy, and another patient, with primary sclerosing cholangitis, developed adenocarcinoma 7.5 years after her initial polypectomy. There was no significant difference in the prevalence of polyp formation on follow-up evaluation between UC patients with an adenoma-like DALM (62.5%) and UC patients with a sporadic adenoma (50%), or between either of these 2 UC patient subgroups and the non-UC sporadic adenoma patient group (49%; P > 0.05). CONCLUSIONS: UC patients who develop an adenoma-like DALM may be treated adequately by polypectomy with complete excision and continued endoscopic surveillance.
Robert D Odze; Francis A Farraye; Jonathan L Hecht; Jason L Hornick
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  2     ISSN:  1542-3565     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-29     Completed Date:  2004-09-22     Revised Date:  2006-09-18    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  534-41     Citation Subset:  IM    
Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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MeSH Terms
Adenoma / complications,  pathology,  surgery*
Analysis of Variance
Case-Control Studies
Colectomy / methods*
Colitis, Ulcerative / complications,  pathology,  therapy*
Colonic Polyps / complications,  pathology,  surgery*
Colonoscopy / methods
Follow-Up Studies
Middle Aged
Retrospective Studies
Risk Assessment
Time Factors
Comment In:
Clin Gastroenterol Hepatol. 2004 Jul;2(7):531-3   [PMID:  15224276 ]

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