Postcolorectal Endoscopic Mucosal Resection Follow-up Is Essential

There is a well-known risk of adenoma recurrence after piecemeal endoscopic mucosal resection (EMR). 

In a single-center study of 2411 nonpedunculated lesions ≥20 mm in size, with complete EMR and no submucosal invasion by pathologic assessment, the overall recurrence rates at first, second, and third follow-ups were 15.2%, 3.4%, and 1.1%, respectively. Of 155 first overt recurrences treated endoscopically and followed, the rate of residual polyp at the next follow-up was 14.8%. Of 17 lesions that recurred overtly twice and were followed, 94.1% were successfully eradicated by the second treatment. Three patients developed adenocarcinoma at the EMR site during follow-up. Although the study was performed at a referral center, overall, 27.5% of patients did not return for the first follow-up, 40.8% did not return for the second follow-up, and 55.9% did not return for the third follow-up.