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- Title
Analysis of the Characteristics of Coexisting Lesions in Colorectal Cancer Patients in an International Study: A Subgroup Analysis of the ATLAS Trial.
- Authors
Yoshida, Naohisa; Suzuki, Sho; Inoue, Ken; Aniwan, Satimai; Chiu, Han-Mo; Laohavichitra, Kannikar; Chirapongsathorn, Sakkarin; Yamamura, Takeshi; Kuo, Chen-Ya; Ang, Tiing Leong; Takezawa, Takahito; Rerknimitr, Rungsun; Ishikawa, Hideki
- Abstract
Introduction: We investigated coexisting lesion types in patients with invasive colorectal cancer (CRC) in a multinational study for comprehending the adenoma-carcinoma and serrated pathway about the development of CRC. Methods: We retrospectively reviewed 3,050 patients enrolled in the international randomized controlled trial (ATLAS study) to evaluate the colorectal polyp detection performance of image-enhanced endoscopy in 11 institutions in four Asian countries/regions. In the current study, as a subgroup analysis of the ATLAS study, 92 CRC patients were extracted and compared to 2,958 patients without CRC to examine the effects of age, sex, and coexisting lesion types (high-grade adenoma [HGA], low-grade adenoma with villous component [LGAV], 10 adenomas, adenoma ≥10 mm, sessile serrated lesions [SSLs], and SSLs with dysplasia [SSLD]). Additional analyses of coexisting lesion types were performed according to sex and location of CRC (right- or left-sided). Results: A multivariate analysis showed that HGA (odds ratio [95% confidence interval] 4.29 [2.16–8.18]; p < 0.01), LGAV (3.02 [1.16–7.83], p = 0.02), and age (1.04 [1.01–1.06], p = 0.01) were independently associated with CRC. According to sex, the coexisting lesion types significantly associated with CRC were LGAV (5.58 [1.94–16.0], p < 0.01) and HGA (4.46 [1.95–10.20], p < 0.01) in males and HGA (4.82 [1.47–15.80], p < 0.01) in females. Regarding the location of CRC, SSLD (21.9 [1.31–365.0], p = 0.03) was significant for right-sided CRC, and HGA (5.22 [2.39–11.4], p < 0.01) and LGAV (3.46 [1.13–10.6], p = 0.02) were significant for left-sided CRC. Conclusions: The significant coexisting lesions in CRC differed according to sex and location. These findings may contribute to comprehending the pathogenesis of CRC.
- Subjects
COLORECTAL cancer; COLON polyps; RANDOMIZED controlled trials; ADENOMA; CANCER invasiveness
- Publication
Digestion, 2024, Vol 105, Issue 4, p280
- ISSN
0012-2823
- Publication type
Article
- DOI
10.1159/000538955