PREDICTORS OF THE EARLY DEVELOPMENT OF ADVANCED METACHRONOUS COLON ADENOMAS

Background/Aims: In order to reduce the number of colonoscopies perfor med for the surveillance of patients after polypectomy, suitable predi ctors of adenomas recurrence are needed. The aim of this study was to find predictors of the early development of metachronous adenomas and specifically of advanced ones. Materials and Methods: Forty-four patie nts underwent total colonoscopy 24-26 months after initial endoscopic polypectomy. All polyps were endoscopically removed and an adenoma was considered as advanced if the diameter was >1 cm and/or villous compo nent and/or severe dysplasia were present. Results: Metachronous adeno mas were detected in 16 (36.4%) patients. Five (11.4%) of them had adv anced metachronous adenomas. Early recurrence of adenomas was signific antly correlated with the total number of indices adenomas (p=0.027). On the contrary, the presence of metachronous adenomas was not related to any of the patients' characteristics nor to the site and the histo logy of the indices adenomas. The development of advanced metachronous adenomas during the same period was significantly correlated with pat ients' age, as it was observed only in patients aged greater than or e qual to 60 years (5/21 or 23.8%) and in none of the patients aged <60 years (Odds ratio: 15.7, p=0.02). Logistic regression analysis reveale d that patient's age was the only significant predictor of the early d evelopment of advanced metachronous adenomas (beta=0.40, p=0.02) and t hat the number of the indices adenomas was the only significant predic tor for the recurrence of all adenomas (beta=1.59, p=0.02). Conclusion s: 1. Only patients aged greater than or equal to 60 years seem to dev elop advanced metachronous adenomas two years after polypectomy and 2. The likelihood for developing metachronous adenomas during the same p eriod is related to the number of indices adenomas.