Malignant progression and recurrence rates following endoscopic treatment of gastric hyperplastic polyps

Evidence supporting management algorithms for gastric hyperplastic polyps (GHPs) remains insufficient. To reassess the treatment criteria for these lesions, we analyzed the rate of neoplastic progression and recurrence after endoscopic resection.This retrospective study from a high-volume center inc...

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Vydané v:Endoscopy Ročník 57; číslo 12; s. 1348
Hlavní autori: Turkot, Maryla H, Zaborowska, Marta, Pilonis, Nastazja D, Lenarcik, Małgorzata, Mróz, Andrzej, Wojciechowska, Urszula, Didkowska, Joanna, Rupinski, Maciej, Regula, Jaroslaw, Kaminski, Michal F, Januszewicz, Wladyslaw
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Germany 01.08.2025
Predmet:
Adenomatous Polyps - pathology
Adenomatous Polyps - surgery
Aged
Disease Progression
Female
Follow-Up Studies
Gastroscopy
Humans
Hyperplasia - surgery
Male
Middle Aged
Neoplasm Recurrence, Local - epidemiology
Neoplasm Recurrence, Local - pathology
Retrospective Studies
Risk Factors
Stomach Neoplasms - epidemiology
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
ISSN:1438-8812, 1438-8812
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Abstract Evidence supporting management algorithms for gastric hyperplastic polyps (GHPs) remains insufficient. To reassess the treatment criteria for these lesions, we analyzed the rate of neoplastic progression and recurrence after endoscopic resection.This retrospective study from a high-volume center included all patients diagnosed with GHPs between 2003 and 2022. We cross-referenced patient records with the National Cancer Registry to identify cases of subsequent gastric cancer, irrespective of endoscopic management. We evaluated the prevalence of neoplastic components within resected GHPs and examined associated risk factors. Finally, we assessed the local recurrence rate at endoscopic follow-up in patients who underwent endoscopic resection.889 patients were included (mean age 63.5 years; 66.9% female), with a median polyp size of 4 mm (interquartile range [IQR] 3-8 mm). Over a median follow-up of 30.5 months (IQR 11.1-61.2), gastric cancer developed in three patients (0.3%), yielding a cumulative incidence of 1.37% (95%CI 0.43%-4.30%). Of the 515 resected GHPs, neoplasia was found in 6 (1.2%), all measuring ≥20 mm and predominantly (5/6) with pedunculated morphology. Patient age (odds ratio [OR] 1.15, 95%CI 1.01-1.36; P = 0.04) and polyp size (OR 1.19, 95%CI 1.11-1.30; P < 0.001) were associated with neoplasia. Among 167 patients (32.4%) with follow-up data, 42 (25.1%) developed local recurrence.The risk of malignant progression in GHPs is low, while local recurrence after endoscopic resection remains notable. Endoscopic treatment should be prioritized for pedunculated polyps ≥20 mm, as these are more likely to harbor neoplasia.
AbstractList Evidence supporting management algorithms for gastric hyperplastic polyps (GHPs) remains insufficient. To reassess the treatment criteria for these lesions, we analyzed the rate of neoplastic progression and recurrence after endoscopic resection.This retrospective study from a high-volume center included all patients diagnosed with GHPs between 2003 and 2022. We cross-referenced patient records with the National Cancer Registry to identify cases of subsequent gastric cancer, irrespective of endoscopic management. We evaluated the prevalence of neoplastic components within resected GHPs and examined associated risk factors. Finally, we assessed the local recurrence rate at endoscopic follow-up in patients who underwent endoscopic resection.889 patients were included (mean age 63.5 years; 66.9% female), with a median polyp size of 4 mm (interquartile range [IQR] 3-8 mm). Over a median follow-up of 30.5 months (IQR 11.1-61.2), gastric cancer developed in three patients (0.3%), yielding a cumulative incidence of 1.37% (95%CI 0.43%-4.30%). Of the 515 resected GHPs, neoplasia was found in 6 (1.2%), all measuring ≥20 mm and predominantly (5/6) with pedunculated morphology. Patient age (odds ratio [OR] 1.15, 95%CI 1.01-1.36; P = 0.04) and polyp size (OR 1.19, 95%CI 1.11-1.30; P < 0.001) were associated with neoplasia. Among 167 patients (32.4%) with follow-up data, 42 (25.1%) developed local recurrence.The risk of malignant progression in GHPs is low, while local recurrence after endoscopic resection remains notable. Endoscopic treatment should be prioritized for pedunculated polyps ≥20 mm, as these are more likely to harbor neoplasia.
The evidence supporting gastric hyperplastic polyps (GHPs) management algorithms remains insufficient. To reassess the treatment criteria of these lesions, we analyzed the rate of GHPs' neoplastic progression and recurrence after endoscopic resection.BACKGROUND AND STUDY AIMSThe evidence supporting gastric hyperplastic polyps (GHPs) management algorithms remains insufficient. To reassess the treatment criteria of these lesions, we analyzed the rate of GHPs' neoplastic progression and recurrence after endoscopic resection.In this retrospective study from a high-volume center, we identified all patients diagnosed with GHPs between 2003 and 2022. Firstly, we cross-referenced patient records with the National Cancer Registry to identify cases of subsequent gastric cancer(GC), irrespective of endoscopic management. Secondly, we evaluated the prevalence of neoplastic components within resected GHPs and examined associated risk factors. Lastly, we analyzed patients who underwent endoscopic resection to assess the rate of local recurrences at endoscopic follow-up.PATIENTS AND METHODSIn this retrospective study from a high-volume center, we identified all patients diagnosed with GHPs between 2003 and 2022. Firstly, we cross-referenced patient records with the National Cancer Registry to identify cases of subsequent gastric cancer(GC), irrespective of endoscopic management. Secondly, we evaluated the prevalence of neoplastic components within resected GHPs and examined associated risk factors. Lastly, we analyzed patients who underwent endoscopic resection to assess the rate of local recurrences at endoscopic follow-up.A total of 889 patients were included (mean age 63.5 years; 66.9% female), with a median polyp size of 4mm (IQR 3-8mm). Over a median follow-up of 30.5 months (IQR: 11.1 - 61.2), GC developed in 3 patients (0.3%), yielding a cumulative incidence of 1.37% (95%CI:0.43%-4.30%). Of the 515 resected GHPs, neoplasia was found in 6 polyps(1.2%), all measuring ≥20mm, predominantly with pedunculated morphology (5/6 cases). Patients' age (odds ratio[OR] 1.15; 95%CI:1.01-1.36, p=0.040), and polyp size (OR 1.19; 95%CI:1.11-1.30, p<0.001) were associated with neoplasia. Follow-up data were available for 167 patients (32.4%), of whom 42(25.1%) developed local recurrence. Conclusions The risk of malignant progression in GHPs is low, while local recurrence after endoscopic resection remains notable. Endoscopic treatment should be prioritized for pedunculated polyps ≥20mm, as these are more likely to harbor neoplasia.RESULTSA total of 889 patients were included (mean age 63.5 years; 66.9% female), with a median polyp size of 4mm (IQR 3-8mm). Over a median follow-up of 30.5 months (IQR: 11.1 - 61.2), GC developed in 3 patients (0.3%), yielding a cumulative incidence of 1.37% (95%CI:0.43%-4.30%). Of the 515 resected GHPs, neoplasia was found in 6 polyps(1.2%), all measuring ≥20mm, predominantly with pedunculated morphology (5/6 cases). Patients' age (odds ratio[OR] 1.15; 95%CI:1.01-1.36, p=0.040), and polyp size (OR 1.19; 95%CI:1.11-1.30, p<0.001) were associated with neoplasia. Follow-up data were available for 167 patients (32.4%), of whom 42(25.1%) developed local recurrence. Conclusions The risk of malignant progression in GHPs is low, while local recurrence after endoscopic resection remains notable. Endoscopic treatment should be prioritized for pedunculated polyps ≥20mm, as these are more likely to harbor neoplasia.
Author Turkot, Maryla H
Regula, Jaroslaw
Zaborowska, Marta
Rupinski, Maciej
Januszewicz, Wladyslaw
Pilonis, Nastazja D
Lenarcik, Małgorzata
Mróz, Andrzej
Didkowska, Joanna
Kaminski, Michal F
Wojciechowska, Urszula
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  givenname: Maryla H
  surname: Turkot
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  organization: Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
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  givenname: Marta
  surname: Zaborowska
  fullname: Zaborowska, Marta
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  orcidid: 0000-0001-7071-3151
  surname: Regula
  fullname: Regula, Jaroslaw
  organization: Department of Oncological Gastroenterology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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  givenname: Michal F
  orcidid: 0000-0002-9714-6457
  surname: Kaminski
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  givenname: Wladyslaw
  orcidid: 0000-0002-8200-2661
  surname: Januszewicz
  fullname: Januszewicz, Wladyslaw
  organization: Department of Oncological Gastroenterology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Snippet Evidence supporting management algorithms for gastric hyperplastic polyps (GHPs) remains insufficient. To reassess the treatment criteria for these lesions, we...
The evidence supporting gastric hyperplastic polyps (GHPs) management algorithms remains insufficient. To reassess the treatment criteria of these lesions, we...
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SubjectTerms Adenomatous Polyps - pathology
Adenomatous Polyps - surgery
Aged
Disease Progression
Female
Follow-Up Studies
Gastroscopy
Humans
Hyperplasia - surgery
Male
Middle Aged
Neoplasm Recurrence, Local - epidemiology
Neoplasm Recurrence, Local - pathology
Retrospective Studies
Risk Factors
Stomach Neoplasms - epidemiology
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Title Malignant progression and recurrence rates following endoscopic treatment of gastric hyperplastic polyps
URI https://www.ncbi.nlm.nih.gov/pubmed/40489992
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