Prognostic model for patients treated for colorectal adenomas with regard to development of recurrent adenomas and carcinoma.

OBJECTIVE

To quantify the risk of developing recurrent adenomas or colorectal cancer for patients who had already had colorectal adenomas removed.

DESIGN

Retrospective study.

SETTING

University hospital, Denmark.

SUBJECTS: 479 patients who had colorectal adenomas removed between 1958-80.

INTERVENTIONS: All patients were followed up by rectoscopy and double contrast barium enema. The survival data were analysed by Cox's proportional hazards model.

MAIN OUTCOME MEASURES: Variables of significant prognostic importance for recurrence of adenomas and the development of cancer were identified. Results. For the long term risk of recurrence of the adenoma (more than 1.5 years after removal of the first adenoma), two variables were of prognostic significance: The occurrence of synchronous adenomas or recurrent adenomas, and the sex of the patient. The model for development of colorectal cancer identified two variables of prognostic significance: the grade of dysplasia and the size of the first adenoma.

CONCLUSION

We suggest that these variables can be used in the management of patients with adenomas, particularly in developing individual follow-up regimens.