High Synchronous Neoplasia Burden in Patients With Large Pedunculated Colon Polyps

High Synchronous Neoplasia Burden in Patients With Large Pedunculated Colon Polyps

Douglas K. Rex, MD, MASGE, reviewing El Rahyel A, et al. Endoscopy 2022 Nov 10.

Previous studies have found that patients with large (≥20 mm) nonpedunculated colorectal polyps have a high prevalence of synchronous colorectal neoplasia. This study investigated synchronous neoplasia in patients with large (≥20 mm) pedunculated lesions (L-PED), using patients with large nonpedunculated lesions (L-NPED) as controls. 

At least 1 synchronous precancerous lesion was found in 85% of the L-PED group versus 89% of the L-NPED group. The L-PED group had a mean 4.8 synchronous conventional adenomas, 56% had ≥1 synchronous high-risk lesion (advanced adenoma or advanced serrated lesions), 49% had ≥1 synchronous advanced conventional adenoma, and 19% had a synchronous neoplastic lesion ≥20 mm. Overall rates of synchronous polyps, adenomas, and sessile serrated lesions were comparable between the 2 groups, and the L-PED group had a higher rate of synchronous lesions with villous elements (27% vs 16%) and synchronous pedunculated polyps (33% vs 10%).

Douglas K. Rex, MD, FASGE

COMMENT

These data indicate that patients with large (≥20 mm) colorectal lesions, whether pedunculated or nonpedunculated, require detailed clearing of the entire colorectum for synchronous disease.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

El Rahyel A, Lahr RE, Rex DK. Prevalence of synchronous neoplasia in patients with large pedunculated colorectal polyps. Endoscopy 2022 Nov 10. (Epub ahead of print) (https://doi.org/10.1055/a-1976-4757

Scroll to Top