How to identify patients who are less likely to have metachronous neoplasms after a colon cancer: A predictive model

Leonardo Frazzoni; Liboria Laterza; Lucrezia Laterza; Alessandro Mussetto; Rocco Maurizio Zagari; Cristina Trovato; Mario De Bellis; Marinella De Bellis; Silvia Paggi; Stefania Piccirelli; Luigi Ricciardiello; Paola Cesaro; Cristiano Spada; Giulia Dal Piaz; Marina La Marca; Fabio Fabbian; Laura Petrella; Luigi Petrella; Veronica Smania; Pietro Marone; Fabiana Tatangelo; Franco Bazzoli; Franco Radaelli; Alessandro Repici; Cesare Hassan; Michele Scagliarini; Lorenzo Fuccio

doi:10.1055/a-1041-2945

How to identify patients who are less likely to have metachronous neoplasms after a colon cancer: A predictive model

Leonardo Frazzoni, Liboria Laterza, Lucrezia Laterza, Alessandro Mussetto, Rocco Maurizio Zagari, Cristina Trovato, Mario De Bellis, Marinella De Bellis, Silvia Paggi, Stefania Piccirelli, Luigi Ricciardiello, Paola Cesaro, Cristiano Spada, Giulia Dal Piaz, Marina La Marca, Fabio Fabbian, Laura Petrella, Luigi Petrella, Veronica Smania, Pietro MaroneFabiana Tatangelo, Franco Bazzoli, Franco Radaelli, Alessandro Repici, Cesare Hassan, Michele Scagliarini, Lorenzo Fuccio

Risultato della ricerca: Contributo in rivista › Articolo in rivista

Abstract

Background âPatients with prior colon cancer have increased risk of metachronous colorectal neoplasms; therefore, endoscopic surveillance is indicated. Current recommendations are not risk-stratified. We investigated predictive factors for colorectal neoplasms to build a model to spare colonoscopies for low-risk patients. Methods â This was a multicenter, retrospective study including patients who underwent surgery for colon cancer in 2001âŠ-âŠ2008 (derivation cohort) and 2009âŠ-âŠ2013 (validation cohort). A predictive model for neoplasm occurrence at second surveillance colonoscopy was developed and validated. Results â 421 and 203 patients were included in derivation and validation cohort, respectively. At second surveillance colonoscopy, 112 (26.6âŠ%) and 55 (27.1âŠ%) patients had metachronous neoplasms in derivation and validation groups; three cancers were detected in the latter. History of left-sided colon cancer (OR 1.64, 95âŠ%CI 1.02âŠ-âŠ2.64), ≥âŠ1 advanced adenoma at index colonoscopy (OR 1.90, 95âŠ%CI 1.05âŠ-âŠ3.43), and ≥âŠ1 adenoma at first surveillance colonoscopy (OR 2.06, 95âŠ%CI 1.29âŠ-âŠ3.27) were independently predictive of metachronous colorectal neoplasms at second surveillance colonoscopy. For patients without such risk factors, diagnostic accuracy parameters were: 89.3âŠ% (95âŠ%CI 82.0âŠ%-94.3âŠ%) and 78.2âŠ% (95âŠ%CI 65.0âŠ%-88.2âŠ%) sensitivity, and 28.5âŠ% (95âŠ%CI 23.5âŠ%-33.9âŠ%) and 33.8âŠ% (95âŠ%CI 26.2âŠ%-42.0âŠ%) specificity in derivation and validation group, respectively. No cancer would be missed. Conclusions â Patients with prior left-sided colon cancer or ≥âŠ1 advanced adenoma at index colonoscopy or ≥âŠ1 adenoma at first surveillance colonoscopy had a significantly higher risk of neoplasms at second surveillance colonoscopy; patients without such factors had much lower risk and could safely skip the second surveillance colonoscopy. A prospective, multicenter validation study is needed.

Lingua originale	English
pagine (da-a)	220-226
Numero di pagine	7
Rivista	Endoscopy
Volume	52
DOI	https://doi.org/10.1055/a-1041-2945
Stato di pubblicazione	Pubblicato - 2020

Keywords

metachronous neoplasms

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Frazzoni, L., Laterza, L., Laterza, L., Mussetto, A., Zagari, R. M., Trovato, C., De Bellis, M., De Bellis, M., Paggi, S., Piccirelli, S., Ricciardiello, L., Cesaro, P., Spada, C., Dal Piaz, G., La Marca, M., Fabbian, F., Petrella, L., Petrella, L., Smania, V., ... Fuccio, L. (2020). How to identify patients who are less likely to have metachronous neoplasms after a colon cancer: A predictive model. Endoscopy, 52, 220-226. https://doi.org/10.1055/a-1041-2945

@article{05e1f4a7f36f49418fd0166399c447cb,

title = "How to identify patients who are less likely to have metachronous neoplasms after a colon cancer: A predictive model",

abstract = "Background {\^a}Patients with prior colon cancer have increased risk of metachronous colorectal neoplasms; therefore, endoscopic surveillance is indicated. Current recommendations are not risk-stratified. We investigated predictive factors for colorectal neoplasms to build a model to spare colonoscopies for low-risk patients. Methods {\^a} This was a multicenter, retrospective study including patients who underwent surgery for colon cancer in 2001{\^a}{\v S}-{\^a}{\v S}2008 (derivation cohort) and 2009{\^a}{\v S}-{\^a}{\v S}2013 (validation cohort). A predictive model for neoplasm occurrence at second surveillance colonoscopy was developed and validated. Results {\^a} 421 and 203 patients were included in derivation and validation cohort, respectively. At second surveillance colonoscopy, 112 (26.6{\^a}{\v S}%) and 55 (27.1{\^a}{\v S}%) patients had metachronous neoplasms in derivation and validation groups; three cancers were detected in the latter. History of left-sided colon cancer (OR 1.64, 95{\^a}{\v S}%CI 1.02{\^a}{\v S}-{\^a}{\v S}2.64), ≥{\^a}{\v S}1 advanced adenoma at index colonoscopy (OR 1.90, 95{\^a}{\v S}%CI 1.05{\^a}{\v S}-{\^a}{\v S}3.43), and ≥{\^a}{\v S}1 adenoma at first surveillance colonoscopy (OR 2.06, 95{\^a}{\v S}%CI 1.29{\^a}{\v S}-{\^a}{\v S}3.27) were independently predictive of metachronous colorectal neoplasms at second surveillance colonoscopy. For patients without such risk factors, diagnostic accuracy parameters were: 89.3{\^a}{\v S}% (95{\^a}{\v S}%CI 82.0{\^a}{\v S}%-94.3{\^a}{\v S}%) and 78.2{\^a}{\v S}% (95{\^a}{\v S}%CI 65.0{\^a}{\v S}%-88.2{\^a}{\v S}%) sensitivity, and 28.5{\^a}{\v S}% (95{\^a}{\v S}%CI 23.5{\^a}{\v S}%-33.9{\^a}{\v S}%) and 33.8{\^a}{\v S}% (95{\^a}{\v S}%CI 26.2{\^a}{\v S}%-42.0{\^a}{\v S}%) specificity in derivation and validation group, respectively. No cancer would be missed. Conclusions {\^a} Patients with prior left-sided colon cancer or ≥{\^a}{\v S}1 advanced adenoma at index colonoscopy or ≥{\^a}{\v S}1 adenoma at first surveillance colonoscopy had a significantly higher risk of neoplasms at second surveillance colonoscopy; patients without such factors had much lower risk and could safely skip the second surveillance colonoscopy. A prospective, multicenter validation study is needed.",

keywords = "metachronous neoplasms, metachronous neoplasms",

author = "Leonardo Frazzoni and Liboria Laterza and Lucrezia Laterza and Alessandro Mussetto and Zagari, {Rocco Maurizio} and Cristina Trovato and {De Bellis}, Mario and {De Bellis}, Marinella and Silvia Paggi and Stefania Piccirelli and Luigi Ricciardiello and Paola Cesaro and Cristiano Spada and {Dal Piaz}, Giulia and {La Marca}, Marina and Fabio Fabbian and Laura Petrella and Luigi Petrella and Veronica Smania and Pietro Marone and Fabiana Tatangelo and Franco Bazzoli and Franco Radaelli and Alessandro Repici and Cesare Hassan and Michele Scagliarini and Lorenzo Fuccio",

year = "2020",

doi = "10.1055/a-1041-2945",

language = "English",

volume = "52",

pages = "220--226",

journal = "Endoscopy",

issn = "0013-726X",

publisher = "Georg Thieme Verlag Stuttgart:Postfach 301120, D-70451 Stuttgart Germany:011 49 711 8931321, EMAIL: [email protected], INTERNET: http://www.thieme.de, Fax: 011 49 711 8931422",

}

Frazzoni, L, Laterza, L, Laterza, L, Mussetto, A, Zagari, RM, Trovato, C, De Bellis, M, De Bellis, M, Paggi, S, Piccirelli, S, Ricciardiello, L, Cesaro, P, Spada, C, Dal Piaz, G, La Marca, M, Fabbian, F, Petrella, L, Petrella, L, Smania, V, Marone, P, Tatangelo, F, Bazzoli, F, Radaelli, F, Repici, A, Hassan, C, Scagliarini, M & Fuccio, L 2020, 'How to identify patients who are less likely to have metachronous neoplasms after a colon cancer: A predictive model', Endoscopy, vol. 52, pagg. 220-226. https://doi.org/10.1055/a-1041-2945

TY - JOUR

T1 - How to identify patients who are less likely to have metachronous neoplasms after a colon cancer: A predictive model

AU - Frazzoni, Leonardo

AU - Laterza, Liboria

AU - Laterza, Lucrezia

AU - Mussetto, Alessandro

AU - Zagari, Rocco Maurizio

AU - Trovato, Cristina

AU - De Bellis, Mario

AU - De Bellis, Marinella

AU - Paggi, Silvia

AU - Piccirelli, Stefania

AU - Ricciardiello, Luigi

AU - Cesaro, Paola

AU - Spada, Cristiano

AU - Dal Piaz, Giulia

AU - La Marca, Marina

AU - Fabbian, Fabio

AU - Petrella, Laura

AU - Petrella, Luigi

AU - Smania, Veronica

AU - Marone, Pietro

AU - Tatangelo, Fabiana

AU - Bazzoli, Franco

AU - Radaelli, Franco

AU - Repici, Alessandro

AU - Hassan, Cesare

AU - Scagliarini, Michele

AU - Fuccio, Lorenzo

PY - 2020

Y1 - 2020

N2 - Background âPatients with prior colon cancer have increased risk of metachronous colorectal neoplasms; therefore, endoscopic surveillance is indicated. Current recommendations are not risk-stratified. We investigated predictive factors for colorectal neoplasms to build a model to spare colonoscopies for low-risk patients. Methods â This was a multicenter, retrospective study including patients who underwent surgery for colon cancer in 2001âŠ-âŠ2008 (derivation cohort) and 2009âŠ-âŠ2013 (validation cohort). A predictive model for neoplasm occurrence at second surveillance colonoscopy was developed and validated. Results â 421 and 203 patients were included in derivation and validation cohort, respectively. At second surveillance colonoscopy, 112 (26.6âŠ%) and 55 (27.1âŠ%) patients had metachronous neoplasms in derivation and validation groups; three cancers were detected in the latter. History of left-sided colon cancer (OR 1.64, 95âŠ%CI 1.02âŠ-âŠ2.64), ≥âŠ1 advanced adenoma at index colonoscopy (OR 1.90, 95âŠ%CI 1.05âŠ-âŠ3.43), and ≥âŠ1 adenoma at first surveillance colonoscopy (OR 2.06, 95âŠ%CI 1.29âŠ-âŠ3.27) were independently predictive of metachronous colorectal neoplasms at second surveillance colonoscopy. For patients without such risk factors, diagnostic accuracy parameters were: 89.3âŠ% (95âŠ%CI 82.0âŠ%-94.3âŠ%) and 78.2âŠ% (95âŠ%CI 65.0âŠ%-88.2âŠ%) sensitivity, and 28.5âŠ% (95âŠ%CI 23.5âŠ%-33.9âŠ%) and 33.8âŠ% (95âŠ%CI 26.2âŠ%-42.0âŠ%) specificity in derivation and validation group, respectively. No cancer would be missed. Conclusions â Patients with prior left-sided colon cancer or ≥âŠ1 advanced adenoma at index colonoscopy or ≥âŠ1 adenoma at first surveillance colonoscopy had a significantly higher risk of neoplasms at second surveillance colonoscopy; patients without such factors had much lower risk and could safely skip the second surveillance colonoscopy. A prospective, multicenter validation study is needed.

AB - Background âPatients with prior colon cancer have increased risk of metachronous colorectal neoplasms; therefore, endoscopic surveillance is indicated. Current recommendations are not risk-stratified. We investigated predictive factors for colorectal neoplasms to build a model to spare colonoscopies for low-risk patients. Methods â This was a multicenter, retrospective study including patients who underwent surgery for colon cancer in 2001âŠ-âŠ2008 (derivation cohort) and 2009âŠ-âŠ2013 (validation cohort). A predictive model for neoplasm occurrence at second surveillance colonoscopy was developed and validated. Results â 421 and 203 patients were included in derivation and validation cohort, respectively. At second surveillance colonoscopy, 112 (26.6âŠ%) and 55 (27.1âŠ%) patients had metachronous neoplasms in derivation and validation groups; three cancers were detected in the latter. History of left-sided colon cancer (OR 1.64, 95âŠ%CI 1.02âŠ-âŠ2.64), ≥âŠ1 advanced adenoma at index colonoscopy (OR 1.90, 95âŠ%CI 1.05âŠ-âŠ3.43), and ≥âŠ1 adenoma at first surveillance colonoscopy (OR 2.06, 95âŠ%CI 1.29âŠ-âŠ3.27) were independently predictive of metachronous colorectal neoplasms at second surveillance colonoscopy. For patients without such risk factors, diagnostic accuracy parameters were: 89.3âŠ% (95âŠ%CI 82.0âŠ%-94.3âŠ%) and 78.2âŠ% (95âŠ%CI 65.0âŠ%-88.2âŠ%) sensitivity, and 28.5âŠ% (95âŠ%CI 23.5âŠ%-33.9âŠ%) and 33.8âŠ% (95âŠ%CI 26.2âŠ%-42.0âŠ%) specificity in derivation and validation group, respectively. No cancer would be missed. Conclusions â Patients with prior left-sided colon cancer or ≥âŠ1 advanced adenoma at index colonoscopy or ≥âŠ1 adenoma at first surveillance colonoscopy had a significantly higher risk of neoplasms at second surveillance colonoscopy; patients without such factors had much lower risk and could safely skip the second surveillance colonoscopy. A prospective, multicenter validation study is needed.

KW - metachronous neoplasms

UR - http://hdl.handle.net/10807/250916

U2 - 10.1055/a-1041-2945

DO - 10.1055/a-1041-2945

M3 - Article

SN - 0013-726X

VL - 52

SP - 220

EP - 226

JO - Endoscopy

JF - Endoscopy

ER -

How to identify patients who are less likely to have metachronous neoplasms after a colon cancer: A predictive model

Abstract

Keywords

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