TY - JOUR
T1 - Endoscopic resection of colon dysplasia in patients with inflammatory bowel disease
T2 - a systematic review and meta-analysis
AU - Mohan, Babu P.
AU - Khan, Shahab R.
AU - Chandan, Saurabh
AU - Kassab, Lena L.
AU - Ponnada, Suresh
AU - Asokkumar, Ravishankar
AU - Shen, Bo
AU - Iacucci, Marietta
AU - Navaneethan, Udayakumar
N1 - Funding Information:
DISCLOSURE: The following authors disclosed financial relationships: B. Shen: Consultant for Abbvie and Takeda. M. Iacucci: Research support from NIHR Biomedical Research Centre , Birmingham, UK. U. Navaneethan: Consultant for Takeda, Abbvie, Janssen, and Pfizer. All other authors disclosed no financial relationships.
Funding Information:
DISCLOSURE: The following authors disclosed financial relationships: B. Shen: Consultant for Abbvie and Takeda. M. Iacucci: Research support from NIHR Biomedical Research Centre, Birmingham, UK. U. Navaneethan: Consultant for Takeda, Abbvie, Janssen, and Pfizer. All other authors disclosed no financial relationships.
Publisher Copyright:
© 2021 American Society for Gastrointestinal Endoscopy
PY - 2021/1
Y1 - 2021/1
N2 - Background and Aims: Inflammatory bowel disease (IBD) is a well-known risk factor for colorectal cancer (CRC). Current guidelines propose complete endoscopic resection of dysplasia in IBD patients with close endoscopic follow-up. Current data on the risk of neoplasia after endoscopic resection of dysplasia in IBD patients are limited. Methods: Multiple databases were searched from inception through August 2019 to identify studies that reported on incidence and/or recurrence of neoplasia after resection of dysplasia in patients with IBD. Outcomes from the included studies were pooled to estimate the risk of neoplasia after dysplasia resection in IBD patients. Results: From 18 studies, 1037 IBD patients underwent endoscopic resection for a total of 1428 colonic lesions. After lesion resection, the pooled risk (rate per 1000 person-years of follow-up) of CRC was 2 (95% confidence interval [CI], 0-3), the pooled risk of high-grade dysplasia was 2 (95% CI, 1-3), and the pooled risk of any lesion was 43 (95% CI, 30-57). Meta-regression analysis based on lesion location (right, left), lesion size (mean and/or median size in mm), lesion type (Paris type I, Paris type II), endoscopic resection technique (EMR, endoscopic submucosal dissection, or polypectomy), and lesion histology (low-grade dysplasia, high-grade dysplasia) did not influence the reported outcomes. Conclusions: Risk of CRC after dysplasia resection in IBD patients appears to be low, supporting the current strategy of resection and surveillance.
AB - Background and Aims: Inflammatory bowel disease (IBD) is a well-known risk factor for colorectal cancer (CRC). Current guidelines propose complete endoscopic resection of dysplasia in IBD patients with close endoscopic follow-up. Current data on the risk of neoplasia after endoscopic resection of dysplasia in IBD patients are limited. Methods: Multiple databases were searched from inception through August 2019 to identify studies that reported on incidence and/or recurrence of neoplasia after resection of dysplasia in patients with IBD. Outcomes from the included studies were pooled to estimate the risk of neoplasia after dysplasia resection in IBD patients. Results: From 18 studies, 1037 IBD patients underwent endoscopic resection for a total of 1428 colonic lesions. After lesion resection, the pooled risk (rate per 1000 person-years of follow-up) of CRC was 2 (95% confidence interval [CI], 0-3), the pooled risk of high-grade dysplasia was 2 (95% CI, 1-3), and the pooled risk of any lesion was 43 (95% CI, 30-57). Meta-regression analysis based on lesion location (right, left), lesion size (mean and/or median size in mm), lesion type (Paris type I, Paris type II), endoscopic resection technique (EMR, endoscopic submucosal dissection, or polypectomy), and lesion histology (low-grade dysplasia, high-grade dysplasia) did not influence the reported outcomes. Conclusions: Risk of CRC after dysplasia resection in IBD patients appears to be low, supporting the current strategy of resection and surveillance.
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U2 - 10.1016/j.gie.2020.06.048
DO - 10.1016/j.gie.2020.06.048
M3 - Article
C2 - 32592777
AN - SCOPUS:85096122167
VL - 93
SP - 59-67.e10
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
SN - 0016-5107
IS - 1
ER -