Metachronous XXXX : risk factors and rationale for the surveillance colonoscopy after initial polypectomy.

@entity1 @entity1127 @entity5 @entity189 @entity652 @entity694 @entity34
PURPOSE: We analyzed the possible risk factors for metachronous @entity694 after endoscopic resection of @entity5 . METHODS: Three hundred and twenty-one @entity1 entered the surveillance study after colonoscopic resection of @entity5 between 1985 and 1999. Histology of @entity5 was @entity652 in 214 @entity1 and @entity189 in 107 @entity1 . @entity5 was observed in 196 @entity1 and @entity5 in 125 at initial endoscopy. The median surveillance period was 39 (range, 12-112) months, and the median frequency of surveillance colonoscopy was three (range, 2-10) times. RESULTS: @entity34 were identified in 114 of 321 surveillance cases (36%). In the 114 cases, the number of @entity1 with metachronous @entity652 was 103 (90%) and that of @entity189 was 11 (10%). Clinical characteristics at entry - including age, gender, multiplicity of polyp, histology of polyp, and site of polyp - were not different between @entity1 with @entity5 and those without @entity5 . Kaplan-Meier analysis revealed that @entity1 with a histology of @entity189 and those with @entity1127 at entry developed @entity5 significantly earlier than did @entity1 with initial @entity652 and @entity1127 , respectively ( P<0.001, P<0.001). However, other characteristics at entry did not produce significant differences in the rate of the development of @entity5 using Kaplan-Meier analysis. Proportional hazards model analysis revealed that histology of the initial @entity5 as @entity189 (relative risk, 1.690, 95% confidence interval, 1.118-2.555) and multiplicity (1.472, 1011-2.143) were significant risk factors for metachronous @entity694 . The 75%, 50%, and 25% metachronous @entity5 -free periods after initial polypectomy were 14, 21, and 39 months, respectively. CONCLUSIONS: These results may help optimizing surveillance strategies for metachronous @entity694 and raising the economic benefit of colonoscopy.
