SO36: Incidence of colonic neoplasia in patients with Serrated Polyposis Syndrome who undergo endoscopic surveillance: a multicenter study

Sabela Carballal1, Daniel Rodríguez Alcalde2, Leticia Moreira1, Luis Hernández2, Lorena Rodríguez3, Francisco Rodríguez-Moranta3, Victoria Gonzalo4, Luis Bujanda5, Xavier Bessa6, Carmen Poves7, Joaquin Cubiella8, Inés Castro8, Eloisa Moya9, Susana Orquiñena10., Joan Clofent11, Enrique Quintero12, Pilar Esteban13, Virginia Piñol14, Francisco Javier Fernández15, Rodrigo Jover16, Lucía Cid17, Esteve Saperas18, Miriam Cuatrecasas19, María Vila20, María López-Cerón1, Jorge López-Vicente2, María Liz Leoz1, Liseth Rivero-Sánchez1, Antoni Castells1,María Pellisé1, Francesc Balaguer1.

1 – Gastroenterology, Hospital Clinic of Barcelona. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain.2 – Digestive Disease Section, Hospital Universitario de Móstoles, Madrid, Spain. 3 – Gastroenterology, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain. 4 – Gastroenterology, Hospital Universitari Mútua de Terrassa, Barcelona, Spain. 5 – Gastroenterology Department, Hospital Donostia/Instituto Biodonostia. Universidad del Pais Vasco (UPV/EHU), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), San Sebastián, Spain. 6 – Gastroenterology Department, Hospital del Mar, Barcelona. 7 – Gastroenterology, Hospital Clinico de San Carlos, Madrid, Spain. 8 – Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense. Instituto de Investigación Biomédica Ourense, Pontevedra y VIgo, Ourense, Spain. 9 – Gastroenterology, Hospital Puerta del Hierro, Madrid, Spain. 10 – Gastroenterology, Complejo Hospitalario de Navarra, Navarra, Spain. 11 – Gastroenterology, Hospital de Sagunto, Sagunto, Valencia, Spain. 12 – Gastroenterology, Hospital Universitario de Canarias, Tenerife, Spain. 13 – Gastroenterology, Hospital Morales Mesenguer, Murcia, Spain. 14 – Gastroenterology, Hospital Josep Trueta, Girona, Spain. 15 – Gastroenterology, Hospital Galdakao Usansolo, Vizcaya, Spain. 16 – Gastroenterology, Hospital General de Alicante, Alicante, Spain. 17 – Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain. 18 – Gastroenterology, Hospital General de Catalunya, Barcelona, Spain. 19 – Pathology, Hospital Clinic, Barcelona. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain. 20 – Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain.

Aim

Due to the increased colorectal cancer (CRC) risk in patients with Serrated Polyposis Syndrome (SPS), annual surveillance colonoscopy is currently advised. This multicenter-study was aimed at describing the risk of advanced lesions in SPS patients undergoing surveillance and identifying which factors could predict neoplasia development during follow-up

Method

From March 2013 to April 2015, 296 patients who fulfilled criteria I and/or III for SPS were retrospectively recruited at 18 centers. We selected patients in which a successful clearing colonoscopy was achieved and underwent endoscopic surveillance. Advanced neoplasia (AN) was defined as CRC, advanced adenoma or advanced serrated polyp (SP >1 cm and/or with dysplasia). Cumulative incidence (CI) of AN was calculated by Kaplan-Meier survival analysis. Cox-regression analysis was performed to identify independent predictors of AN development

Results

In 158 SPS patients (mean age: 53 years, 45% female) a total of 321 surveillance colonoscopies were performed (median:2, range:1-7). Four CRC were diagnosed during surveillance (3-year cumulative risk: 3%). Three-year cumulative incidence for AN was 43.7%. Fulfilling both I+III WHO criteria and the presence of advanced-SP at baseline colonoscopy were independent predictors of AN development (OR=2.1;95%CI:1.2-3.8,p=0.008 and OR=2.38;95%CI:1.2-4.4,p=0.006; respectively). During follow-up, 10(6.3%) patients were referred for surgery due to an invasive CRC(n=4, 2.5%) or severe polyposis(n=6, 3.8%)

Conclusion

Patients with SPS have a substantial risk of developing AN under endoscopic surveillance, whereas CRC incidence is low. Close endoscopic surveillance in SPS patients is essential, especially in those with risk factors at baseline colonoscopy

Top