BACKGROUND Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma.The distinctions among subtypes of gastric adenomas have been infrequently explored in existing li...BACKGROUND Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma.The distinctions among subtypes of gastric adenomas have been infrequently explored in existing literature.AIM To assess the subtype-specific risk factors and outcomes of endoscopic resection(ER)for gastric adenomas.METHODS This is a retrospective cohort study.Among 162 patients who underwent ER for gastric lesions larger than 10 mm between 2017 and 2022,79 patients with gastric adenomas were included.Hyperplastic polyps(n=37)and subepithelial lesions(n=46)were excluded.Logistic regression and survival analyses were conducted.RESULTS The 79 patients(mean age 68.1 years;65%male)had adenoma subtypes:62%intestinal,29%foveolar,8%pyloric,and 1%oxyntic.The mean follow-up was 26 months.Intestinal adenoma was strongly linked to a family history of gastric adenocarcinoma and atrophic gastritis(P<0.001);foveolar adenoma was significantly associated with intestinal metaplasia(P<0.001).Pyloric adenomas had the largest polyp size(P<0.001).Recurrence rates were 8%,17%,and 17%for the respective subtypes(P=0.07),with no significant difference in the meantime to recurrence(P=0.8).Independent predictors of recurrence after ER included a family history of gastric adenocarcinoma,active Helicobacter pylori infection,polyp size≥30 mm,presence of>3 polyps and Paris 0-IIc morphology(P<0.001).CONCLUSION This study identifies distinct risk factor profiles for different subtypes of gastric adenomas and independent recurrence predictors post-ER,underscoring the importance of subtype-specific tailored risk assessment and surveillance strategies.展开更多
Background:Obesity is associated with increased oncological risk and outcomes but the evidence surrounding the effect of body mass index(BMI)on increased risk of hepatocellular carcinoma(HCC)recurrence after liver tra...Background:Obesity is associated with increased oncological risk and outcomes but the evidence surrounding the effect of body mass index(BMI)on increased risk of hepatocellular carcinoma(HCC)recurrence after liver transplantation(LT)is still questionable.The purpose of this retrospective study of a large cohort of adult patients transplanted for HCC was to investigate the effect of BMI on the incidence of HCC recurrence and outcome.Methods:Data from 427 adult recipients transplanted for HCC between 2000 and 2017 were collected.Patients were classified at time of LT according to the World Health Organization BMI classification into 3 groups;group 1:BMI<25(n=166),group 2:BMI 25-29.9(n=150)and group 3:BMI≥30(n=111).Results:There were no significant changes of mean BMI overtime 26.8±5.0 kg/m2 at time of LT and 28.8±23.1 at 5 years.The recurrence rates of HCC after LT in the three groups were 19%,16%and 17%respectively.The 5,10 and 15-year recurrence free survival(RFS)rates were respectively 68.6%,47.3%and 40.8%in group 1,73.3%,66.2%and 49.5%in group 2 and 68.8%,57.5%and 47.7%in group 3(log rank P=0.47).Conclusions:Recipient BMI at time of transplant and during follow-up didn’t impact the incidence of HCC recurrence nor long-term patient survival,irrespective to the status of the patients and their tumor characteristic at time of LT.The present study clearly confirms that obesity should not be considered,when selecting patients with HCC to LT,as a predictive factor of recurrence.展开更多
文摘BACKGROUND Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma.The distinctions among subtypes of gastric adenomas have been infrequently explored in existing literature.AIM To assess the subtype-specific risk factors and outcomes of endoscopic resection(ER)for gastric adenomas.METHODS This is a retrospective cohort study.Among 162 patients who underwent ER for gastric lesions larger than 10 mm between 2017 and 2022,79 patients with gastric adenomas were included.Hyperplastic polyps(n=37)and subepithelial lesions(n=46)were excluded.Logistic regression and survival analyses were conducted.RESULTS The 79 patients(mean age 68.1 years;65%male)had adenoma subtypes:62%intestinal,29%foveolar,8%pyloric,and 1%oxyntic.The mean follow-up was 26 months.Intestinal adenoma was strongly linked to a family history of gastric adenocarcinoma and atrophic gastritis(P<0.001);foveolar adenoma was significantly associated with intestinal metaplasia(P<0.001).Pyloric adenomas had the largest polyp size(P<0.001).Recurrence rates were 8%,17%,and 17%for the respective subtypes(P=0.07),with no significant difference in the meantime to recurrence(P=0.8).Independent predictors of recurrence after ER included a family history of gastric adenocarcinoma,active Helicobacter pylori infection,polyp size≥30 mm,presence of>3 polyps and Paris 0-IIc morphology(P<0.001).CONCLUSION This study identifies distinct risk factor profiles for different subtypes of gastric adenomas and independent recurrence predictors post-ER,underscoring the importance of subtype-specific tailored risk assessment and surveillance strategies.
文摘Background:Obesity is associated with increased oncological risk and outcomes but the evidence surrounding the effect of body mass index(BMI)on increased risk of hepatocellular carcinoma(HCC)recurrence after liver transplantation(LT)is still questionable.The purpose of this retrospective study of a large cohort of adult patients transplanted for HCC was to investigate the effect of BMI on the incidence of HCC recurrence and outcome.Methods:Data from 427 adult recipients transplanted for HCC between 2000 and 2017 were collected.Patients were classified at time of LT according to the World Health Organization BMI classification into 3 groups;group 1:BMI<25(n=166),group 2:BMI 25-29.9(n=150)and group 3:BMI≥30(n=111).Results:There were no significant changes of mean BMI overtime 26.8±5.0 kg/m2 at time of LT and 28.8±23.1 at 5 years.The recurrence rates of HCC after LT in the three groups were 19%,16%and 17%respectively.The 5,10 and 15-year recurrence free survival(RFS)rates were respectively 68.6%,47.3%and 40.8%in group 1,73.3%,66.2%and 49.5%in group 2 and 68.8%,57.5%and 47.7%in group 3(log rank P=0.47).Conclusions:Recipient BMI at time of transplant and during follow-up didn’t impact the incidence of HCC recurrence nor long-term patient survival,irrespective to the status of the patients and their tumor characteristic at time of LT.The present study clearly confirms that obesity should not be considered,when selecting patients with HCC to LT,as a predictive factor of recurrence.
