Background and Aims
Nonampullary duodenal adenomas are either sporadic or associated with a hereditary
syndrome such as familial adenomatous polyposis (FAP). The aim of this study is to
compare characteristics and outcomes of sporadic and FAP-associated duodenal adenomas.
Methods
We retrospectively collected clinical, endoscopic, and pathologic data in patients
diagnosed with duodenal adenomas at our institution and included all available follow-up.
Results
Two hundred thirteen subjects were identified; 118 had FAP and 95 had sporadic adenomas.
FAP subjects were more likely to have multifocal disease. Initial size was not significantly
associated with dysplasia. Fourteen (12%) with FAP and 33 (35%) with sporadic adenomas
underwent EMR. Among those subjects who did not undergo EMR or surgery, there was
no difference between the FAP and sporadic groups with progression to new dysplasia or cancer. However, the FAP group was significantly more likely to have
dysplasia at follow-up (P = .05). There was a significant difference in overall survival between the FAP and
sporadic groups (log-rank test, P < .001). In the subgroup of patients aged 40 years old and older who did not undergo
intervention, the FAP group had a shorter time to pathology progression compared with
the similar sporadic subgroup. Range of time to progression to cancer was 3 to 161
months.
Conclusions
FAP subjects were more likely to be younger and have multifocal disease. Progression
of pathology was more likely in the older FAP group compared with the sporadic group.
Time to progression to cancer was widely variable and, therefore, unpredictable.
Abbreviations:
FAP (familial adenomatous polyposis), OS (overall survival)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 13, 2016
Accepted:
August 1,
2016
Received:
December 8,
2015
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
Identification
Copyright
© 2017 by the American Society for Gastrointestinal Endoscopy
