Background and Aims
Data are limited on safety and outcomes of colorectal EMR in octogenarians (≥80 years
old). We sought to review outcome data for patients aged ≥80 in a prospectively collected
database of patients referred for large polyp removal.
Methods
We retrospectively evaluated a database of patients referred for large (≥20 mm) nonpedunculated
polyp removal. From 2000 to 2019, we compared the rates of follow-up, recurrence,
adverse events, and synchronous neoplasia detection between younger patients and patients
aged ≥80.
Results
There were 167 patients aged ≥80 years and 1686 <80 years. Patients in the elderly
group returned for surveillance less often (67.1% vs 75.1%, P = .024), had greater first follow-up recurrence rates (27.5% vs 13.8%, P < .001), but had similar adverse event rates (1.8% vs 2.8%, P = .619) compared with younger patients. Rates of synchronous neoplasia were similar
and high in both groups.
Conclusions
EMR is safe and well tolerated for large polyp removal in patients over 80 years old.
Patients aged ≥80 years are less likely to present for follow-up after EMR. They had
a higher recurrence rate and a similarly high prevalence of synchronous precancerous
lesions. Follow-up after EMR should be encouraged in the elderly, and an attempt to
clear the colon of synchronous disease at the time of the initial EMR may be warranted.
Abbreviations:
APC (argon plasma coagulation), HGD (high-grade dysplasia)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 16, 2020
Accepted:
October 9,
2020
Received:
June 23,
2020
Footnotes
DISCLOSURE: The following author received research support for this study from a gift from Scott Schurz of Bloomington, Indiana and his children to the Indiana University Foundation: D. K. Rex. In addition, the following author disclosed financial relationships: D. K. Rex: Consultant for Olympus Corporation, Boston Scientific, Medtronic, Aries Pharmaceutical, Braintree Laboratories, Lumendi, Ltd., Norgine, Endokey, GI Supply, and Covidian/Medtronic; research support from EndoAid, Olympus Corporation, Medivators, and Erbe USA Inc; ownership in Satisfai Health. All other authors disclosed no financial relationships.
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