This is a retrospective and prospective cohort study designed to evaluate the recurrence rate and identify risk factors after endoscopic resection of gastric and intestinal polyps. BACKGROUND: Gastric and intestinal polyps are common digestive diseases with potential for malignant transformation. Although endoscopic resection is the standard treatment, recurrence rates range from 10-50%, and the mechanisms and risk factors remain unclear. OBJECTIVES: Primary: To assess short-term (1-year) and long-term (3-year) recurrence rates after endoscopic polyp resection Secondary: To identify independent risk factors and develop a recurrence risk prediction model DESIGN: Mixed retrospective-prospective cohort study * Retrospective cohort: Patients who underwent polyp resection from 2021-2022, with follow-up data through 2024 * Prospective cohort: Patients enrolled from 2024-2025, with standardized follow-up through 2028 SETTING: Single tertiary referral center with \>10,000 endoscopic polyp resections performed since 2021 PARTICIPANTS: Approximately 1,600-1,800 adult patients (≥18 years) who underwent complete endoscopic resection of gastric or intestinal polyps FOLLOW-UP: * Short-term: 1 year post-resection (±2 months) * Long-term: 3 years post-resection (±3 months) MAIN OUTCOME: Recurrence rate defined as new polyp detection at original or different sites during endoscopic surveillance POTENTIAL RISK FACTORS: Patient demographics, polyp characteristics (size, number, location, pathology), resection method, Helicobacter pylori status, lifestyle factors, and medication use EXPECTED IMPACT: Results will inform personalized surveillance strategies and optimize resource allocation for post-polypectomy follow-up.
Study Type
OBSERVATIONAL
Enrollment
2,000
The First Hospital of Lanzhou University
Lanzhou, Gansu, China
Short-term Recurrence Rate at 1 Year
New polyp(s) detected by endoscopy and confirmed by pathology at 1-year follow-up. Includes both local recurrence (within 2cm of resection site) and metachronous polyps (\>2cm from original site).
Time frame: 1 year post-resection (10-14 months acceptable)
Long-term Recurrence Rate at 3 Years
New polyp(s) detected by endoscopy and confirmed by pathology at 3-year follow-up. Includes both local recurrence and metachronous polyps.
Time frame: 3 years post-resection (33-39 months acceptable)
Cumulative Recurrence Rate
Overall recurrence rate combining 1-year and 3-year surveillance results
Time frame: Up to 3 years post-resection
Recurrence-free Survival Time
Measured in months; censored at last follow-up for non-recurrent cases
Time frame: Up to 3 years
Characteristics of Recurrent Polyps
Descriptive analysis of recurrent polyp features: Number, size, location, and pathological type of recurrent polyps.
Time frame: At 1-year and 3-year follow-up
Progression to High-grade Dysplasia or Cancer
Pathologically confirmed progression: Proportion of participants developing high-grade dysplasia or invasive cancer during follow-up.
Time frame: Up to 3 years
Re-treatment Rate
Proportion of participants requiring repeat endoscopic or surgical treatment: Includes repeat polypectomy, endoscopic resection, or surgical resection
Time frame: Up to 3 years
Identification of Independent Risk Factors
Hazard ratios (HR) and 95% confidence intervals for each significant risk factor
Time frame: Analysis conducted after all follow-up completed (2029)
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