Randomised comparison of postpolypectomy surveillance intervals following a two-round baseline colonoscopy: the Japan Polyp Study Workgroup.
Randomised comparison of postpolypectomy surveillance intervals following a two-round baseline colonoscopy: the Japan Polyp Study Workgroup.
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DOI：
10.1136/gutjnl-2020-321996
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发表时间：
2020-11-02
期刊：
影响因子：
24.5
通讯作者：
Yoshida S
中科院分区：
文献类型：
--
作者：
Matsuda T;Fujii T;Sano Y;Kudo SE;Oda Y;Hotta K;Shimoda T;Saito Y;Kobayashi N;Sekiguchi M;Konishi K;Ikematsu H;Iishi H;Takeuchi Y;Igarashi M;Kobayashi K;Sada M;Yamaguchi Y;Hasuda K;Shinohara T;Ishikawa H;Murakami Y;Taniguchi H;Fujimori T;Ajioka Y;Yoshida S
评估息肉切除术后仅3年或1年和3年随访结肠镜检查是否能有效检测晚期肿瘤（AN），包括非息肉样结直肠肿瘤（NP-CRN）。在11家日本机构进行了一项前瞻性多中心随机对照试验。入选的参与者接受了两轮基线结肠镜检查（间隔：1年），以清除所有肿瘤病变。随后，他们被随机分配接受随访结肠镜检查在1年和3年（2检查组）或仅在3年（1检查组）。评估了随访结肠镜检查时AN的发生率，AN定义为低度异型增生≥10 mm、高度异型增生或浸润性癌的病变。本研究共入组3926例患者。平均年龄为57.3（范围：40-69）岁，2440例（62%）为男性。其中，2166例患者被分配到两组（2-检查：1087例，1-检查：1079例）。总的来说，我们在两组的28例患者中在随访结肠镜检查中检测到29例AN。在符合方案分析中（2次检查组701例vs 1次检查组763例），两组的AN发生率相似（1.7% vs 2.1%，p=0.599）。非劣效性检验的结果具有显著性（符合方案分析中p=0.017，意向治疗分析中p=0.001）。NP-CRN以AN为主（62%，18/29），多为侧向扩散型（83%，15/18）。在两轮基线结肠镜检查后，3年随访结肠镜检查检测AN，包括NP-CRN，与1年和3年后进行的随访结肠镜检查一样有效。
To assess whether follow-up colonoscopy after polypectomy at 3 years only, or at 1 and 3 years would effectively detect advanced neoplasia (AN), including nonpolypoid colorectal neoplasms (NP-CRNs). A prospective multicentre randomised controlled trial was conducted in 11 Japanese institutions. The enrolled participants underwent a two-round baseline colonoscopy (interval: 1 year) to remove all neoplastic lesions. Subsequently, they were randomly assigned to undergo follow-up colonoscopy at 1 and 3 years (2-examination group) or at 3 years only (1-examination group). The incidence of AN, defined as lesions with low-grade dysplasia ≥10 mm, high-grade dysplasia or invasive cancer, at follow-up colonoscopy was evaluated. A total of 3926 patients were enrolled in this study. The mean age was 57.3 (range: 40–69) years, and 2440 (62%) were male. Of these, 2166 patients were assigned to two groups (2-examination: 1087, 1-examination: 1079). Overall, we detected 29 AN in 28 patients at follow-up colonoscopy in both groups. On per-protocol analysis (701 in 2-examination vs 763 in 1-examination group), the incidence of AN was similar between the two groups (1.7% vs 2.1%, p=0.599). The results of the non-inferiority test were significant (p=0.017 in per-protocol, p=0.001 in intention-to-treat analysis). NP-CRNs composed of dominantly of the detected AN (62%, 18/29), and most of them were classified into laterally spreading tumour non-granular type (83%, 15/18). After a two-round baseline colonoscopy, follow-up colonoscopy at 3 years detected AN, including NP-CRNs, as effectively as follow-up colonoscopies performed after 1 and 3 years.
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DOI：
10.1056/nejmoa1301969
发表时间：
2013-09-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
Nishihara R;Wu K;Lochhead P;Morikawa T;Liao X;Qian ZR;Inamura K;Kim SA;Kuchiba A;Yamauchi M;Imamura Y;Willett WC;Rosner BA;Fuchs CS;Giovannucci E;Ogino S;Chan AT
通讯作者：
Chan AT
影响因子：
9.3
作者：
Hassan, Cesare;Antonelli, Giulio;Quintero, Enrique
通讯作者：
Quintero, Enrique
影响因子：
45.3
作者：
Baxter, Nancy N.;Warren, Joan L.;Doria-Rose, V. Paul
通讯作者：
Doria-Rose, V. Paul
影响因子：
9.3
作者：
Fujii, T;Rembacken, BJ;Axon, ATR
通讯作者：
Axon, ATR
影响因子：
29.4
作者：
Hiraoka, Sakiko;Kato, Jun;Shiratori, Yasushi
通讯作者：
Shiratori, Yasushi