Risk factors of polyp recurrence after colorectal polypectomy

Abstract

Objective To explore the relationship between polyp features at first-time colonoscopy and the recurrence, and to analyze the risk factors of recurrence at different time points of follow-up. Methods The data of 614 patients undergoing colorectal polypectomy between May 2008 and May 2016 were retrospectively analyzed. Patients were classified into 3 groups according to the characteristics and polyp features at first-time colonoscopy. The risk factors influencing polyp recurrence at different time points during follow up were analyzed. Results Univariate analysis showed that age ≥70 years, polyp′s diameter ≥0.5 cm, the number of polyps >2 and distribution throughout colon were risk factors for recurrence. In multivariate models, the number of polyps at baseline was the only significant predictor for recurrence (OR=2.36, 95%CI: 1.06-5.25). All of 614 patients underwent 6-87 months surveillance colonoscopy. The total recurrence rate was 58.6%(360/614). During four different surveillance intervals including 6-24 months, >24-36 months, >36-48 months, and >48-87 months, the cumulative recurrence rate of high-risk group was 60.1%, 65.7%, 80.7%, and 83.8%, respectively, whereas, that of low-risk group was 22.7%, 40.0%, 53.8%, and 65.4%, respectively. There was a significant difference between the two groups (P=0.00). Conclusion The number of initial colorectal polyps is useful for predicting the risk of polyp recurrence, and the rate of polyp recurrence during surveillance increases with the passage of time. The cumulative recurrence rate of high-risk group after polypectomy is significantly higher than that of low-risk group. Key words: Colonoscopy; Intestinal polyps; Risk factors; Recurrence; Surveillance interval