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@ARTICLE{Zhan:131003,
author = {T. Zhan$^*$ and T. Hielscher$^*$ and F. Hahn and C. Hauf
and J. Betge$^*$ and M. P. Ebert and S. Belle},
title = {{R}isk {F}actors for {L}ocal {R}ecurrence of {L}arge,
{F}lat {C}olorectal {P}olyps after {E}ndoscopic {M}ucosal
{R}esection.},
journal = {Digestion},
volume = {93},
number = {4},
issn = {1421-9867},
address = {Basel},
publisher = {Karger},
reportid = {DKFZ-2017-06079},
pages = {311 - 317},
year = {2016},
abstract = {Removal of large, flat colorectal polyps by endoscopic
mucosal resection (EMR) is effective, but local recurrences
occur regularly. This study investigated risk factors for
local recurrence.Cases of EMR of flat colorectal polyps
≥20 mm at an academic center from 2004 to 2011 were
retrospectively analyzed for polyp features, resection
technique, complications and local recurrences. Behavioral
risk factors were retrospectively determined by
self-administered questionnaires.Data were collected for 129
patients $(57.3\%$ male, mean age at time of EMR: 65.0
years). Mean polyp size was 37.2 mm. Polyps were mostly
adenoma with low-grade dysplasia $(58.1\%)$ and
predominantly located in the right colon $(62\%).$ En bloc
resection was performed in $31.8\%.$ The median follow-up
time was 40 months. Local recurrence occurred in $26.3\%$ of
patients, with $87\%$ being recurrence-free after 1 year
$(95\%$ CI $81-93\%).$ A history of smoking was reported by
$51.6\%$ of patients and $88.4\%$ reported regular alcohol
consumption. Univariate analysis showed that polyp size and
piecemeal resection were associated with risk of local
recurrence. In multivariate analysis, only polyp size was
predictive for local recurrence. No association was found
for behavioral risk factors.Polyp size is the main predictor
of local recurrence after EMR of large, flat colorectal
polyps.},
cin = {B110 / C060},
ddc = {610},
cid = {I:(DE-He78)B110-20160331 / I:(DE-He78)C060-20160331},
pnm = {312 - Functional and structural genomics (POF3-312)},
pid = {G:(DE-HGF)POF3-312},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:27271329},
doi = {10.1159/000446364},
url = {https://inrepo02.dkfz.de/record/131003},
}