Recurrence After Gastric and Intestinal Polyp Resection

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.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Age 18 years or older
* First-time endoscopic examination (gastroscopy or colonoscopy) at the study center
* Pathologically confirmed polyp of any type (adenomatous, hyperplastic, inflammatory, fundic gland polyp, hamartomatous, serrated lesion)
* Complete endoscopic resection performed (including EMR, ESD, snare polypectomy, hot biopsy forceps, or argon plasma coagulation)
* Negative resection margins or complete resection assessed by pathology
* At least one follow-up endoscopic examination completed (for retrospective cohort) or willingness to complete follow-up (for prospective cohort)
* Complete baseline clinical data available

Exclusion Criteria:

* Hereditary polyposis syndromes (familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome, juvenile polyposis syndrome)
* Inflammatory bowel disease (ulcerative colitis or Crohn's disease)
* Previous history of gastric or colorectal cancer
* Cancer detected at initial resection (stage T1b or higher)
* Non-polyp pathology (e.g., submucosal tumors, normal mucosa)
* Incomplete resection with positive margins that were not re-treated
* Lost to follow-up with no available surveillance data (for retrospective cohort)
* Pregnancy at time of enrollment
* Inability or unwillingness to provide informed consent (for prospective cohort)

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