Adenomatous Polyps, Colon Polyps, Colorectal Adenoma, Colorectal Polyps, Gastric Adenoma and Early Gastric Cancer, Gastric Polyps, Intestinal Polyps
Conditions
Keywords
Polyp recurrence, Endoscopic resection, Polypectomy, Endoscopic mucosal resection, Endoscopic submucosal dissection, Risk factors, Surveillance, Follow-up, Adenoma, Gastric polyp, Colorectal polyp
Brief summary
This is a retrospective and prospective cohort study designed to evaluate the recurrence rate and identify risk factors after endoscopic resection of gastric and intestinal polyps. BACKGROUND: Gastric and intestinal polyps are common digestive diseases with potential for malignant transformation. Although endoscopic resection is the standard treatment, recurrence rates range from 10-50%, and the mechanisms and risk factors remain unclear. OBJECTIVES: Primary: To assess short-term (1-year) and long-term (3-year) recurrence rates after endoscopic polyp resection Secondary: To identify independent risk factors and develop a recurrence risk prediction model DESIGN: Mixed retrospective-prospective cohort study * Retrospective cohort: Patients who underwent polyp resection from 2021-2022, with follow-up data through 2024 * Prospective cohort: Patients enrolled from 2024-2025, with standardized follow-up through 2028 SETTING: Single tertiary referral center with \>10,000 endoscopic polyp resections performed since 2021 PARTICIPANTS: Approximately 1,600-1,800 adult patients (≥18 years) who underwent complete endoscopic resection of gastric or intestinal polyps FOLLOW-UP: * Short-term: 1 year post-resection (±2 months) * Long-term: 3 years post-resection (±3 months) MAIN OUTCOME: Recurrence rate defined as new polyp detection at original or different sites during endoscopic surveillance POTENTIAL RISK FACTORS: Patient demographics, polyp characteristics (size, number, location, pathology), resection method, Helicobacter pylori status, lifestyle factors, and medication use EXPECTED IMPACT: Results will inform personalized surveillance strategies and optimize resource allocation for post-polypectomy follow-up.
Interventions
None listed
Sponsors
LanZhou University
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 years or older * First-time endoscopic examination (gastroscopy or colonoscopy) at the study center * Pathologically confirmed polyp of any type (adenomatous, hyperplastic, inflammatory, fundic gland polyp, hamartomatous, serrated lesion) * Complete endoscopic resection performed (including EMR, ESD, snare polypectomy, hot biopsy forceps, or argon plasma coagulation) * Negative resection margins or complete resection assessed by pathology * At least one follow-up endoscopic examination completed (for retrospective cohort) or willingness to complete follow-up (for prospective cohort) * Complete baseline clinical data available
Exclusion criteria
* Hereditary polyposis syndromes (familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome, juvenile polyposis syndrome) * Inflammatory bowel disease (ulcerative colitis or Crohn's disease) * Previous history of gastric or colorectal cancer * Cancer detected at initial resection (stage T1b or higher) * Non-polyp pathology (e.g., submucosal tumors, normal mucosa) * Incomplete resection with positive margins that were not re-treated * Lost to follow-up with no available surveillance data (for retrospective cohort) * Pregnancy at time of enrollment * Inability or unwillingness to provide informed consent (for prospective cohort)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Short-term Recurrence Rate at 1 Year | 1 year post-resection (10-14 months acceptable) | New polyp(s) detected by endoscopy and confirmed by pathology at 1-year follow-up. Includes both local recurrence (within 2cm of resection site) and metachronous polyps (\>2cm from original site). |
| Long-term Recurrence Rate at 3 Years | 3 years post-resection (33-39 months acceptable) | New polyp(s) detected by endoscopy and confirmed by pathology at 3-year follow-up. Includes both local recurrence and metachronous polyps. |
| Cumulative Recurrence Rate | Up to 3 years post-resection | Overall recurrence rate combining 1-year and 3-year surveillance results |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Recurrence-free Survival Time | Up to 3 years | Measured in months; censored at last follow-up for non-recurrent cases |
| Characteristics of Recurrent Polyps | At 1-year and 3-year follow-up | Descriptive analysis of recurrent polyp features: Number, size, location, and pathological type of recurrent polyps. |
| Progression to High-grade Dysplasia or Cancer | Up to 3 years | Pathologically confirmed progression: Proportion of participants developing high-grade dysplasia or invasive cancer during follow-up. |
| Re-treatment Rate | Up to 3 years | Proportion of participants requiring repeat endoscopic or surgical treatment: Includes repeat polypectomy, endoscopic resection, or surgical resection |
| Identification of Independent Risk Factors | Analysis conducted after all follow-up completed (2029) | Hazard ratios (HR) and 95% confidence intervals for each significant risk factor |
Countries
China
Contacts
CONTACTQiangqiang Tian
Outcome results
None listed