Colorectal tumor comorbidity is common in patients with duodenal tumors: Exploratory cross-sectional study

Mari Mizutani; Motohiko Kato; Kazuhiro Yamanoi; Akiko Matsubara; Atsushi Nakayama; Kayoko Fukuhara; Kentaro Iwata; Kurato Miyazaki; Teppei Masunaga; Yoko Kubosawa; Yukie Hayashi; Yusaku Takatori; Teppei Akimoto; Noriko Matsuura; Rieko Bessho; Tomohisa Sujino; Kaoru Takabayashi; Hitoshi Ichikawa; Kazuhiro Kashiwagi; Hiromasa Takaishi; Yasunori Sato; Takanori Kanai; Ryoji Kushima; Naohisa Yahagi

doi:10.1055/a-2341-9026

Colorectal tumor comorbidity is common in patients with duodenal tumors: Exploratory cross-sectional study

Endosc Int Open. 2024 Oct 28;12(10):E1206-E1213. doi: 10.1055/a-2341-9026. eCollection 2024 Oct.

Authors

Mari Mizutani¹, Motohiko Kato², Kazuhiro Yamanoi³, Akiko Matsubara⁴, Atsushi Nakayama⁵, Kayoko Fukuhara⁶, Kentaro Iwata⁷, Kurato Miyazaki⁷, Teppei Masunaga⁵, Yoko Kubosawa⁷, Yukie Hayashi⁸, Yusaku Takatori⁵, Teppei Akimoto⁵, Noriko Matsuura⁵, Rieko Bessho⁶, Tomohisa Sujino⁹, Kaoru Takabayashi⁹, Hitoshi Ichikawa⁶, Kazuhiro Kashiwagi⁶, Hiromasa Takaishi⁶, Yasunori Sato¹⁰, Takanori Kanai⁷, Ryoji Kushima⁴, Naohisa Yahagi⁵

Affiliations

¹ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine Graduate School of Medicine, Tokyo, Japan.
² Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine Graduate School of Medicine, Tokyo, Japan.
³ Department of Pathology, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan.
⁴ Division of Diagnostic Pathology, Shiga University of Medical Science Hospital, Otsu, Japan.
⁵ Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan.
⁶ Center for Preventive Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan.
⁷ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan.
⁸ Center for Preventive Medicine, Keio University School of Medicine Department of Internal Medicine, Shinjuku-ku, Japan.
⁹ Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan.
¹⁰ Department of Biostatistics, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan.

Abstract

Background and study aims The duodenum and colorectum are target organs for familial colorectal adenomatous polyposis, however, the association of duodenal epithelial tumors (DETs) and colorectal tumors is still controversial. The aim of our study was to elucidate the association between DET and colorectal tumor. Patients and methods This was an exploratory cross-sectional study of patients with DETs treated by endoscopic resection at our hospital, between November 2018 and October 2022. Individuals who underwent colonoscopy as part of the health screening comprised the reference control group for comparison. In both groups, lesions suspected of being tumors were resected. The main outcome was the adenoma detection rate (ADR). Other outcomes were the detection rate for advanced neoplasia (AN) and risk factors for colorectal adenoma and AN, evaluated using univariate and multivariable analyses. Results Analyses were based on data from 163 individuals in the DET group and 177 in the control group. ADR was higher in the DET (63.2%) than in the control (23.6%) group ( P < 0.001). AN and invasive cancer rates were also significantly higher in the DET than in the control group (AN: 20.9% vs 3.4%, respectively, P < 0.001; invasive cancer: 3.1% vs 0%, respectively, P < 0.001). On logistic regression analysis, DET was found to be associated with a 5-fold increase in the detection rate of adenoma and 6-fold increase in AN detection. Conclusions The study revealed significant association between DET and high ADR and a higher frequency of AN and invasive cancer. Screening colonoscopy is suggested for patients with DETs.

Keywords: Colorectal cancer; Endoscopy Lower GI Tract; Endoscopy Small Bowel; Neoplasia; Polyps / adenomas / ....

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