Clinicopathological features and risk factors for developing colorectal neoplasia in Hodgkin’s lymphoma survivors
Digestive Endoscopy, vol. 34, pp. 163–170
Abstract
BACKGROUND: Hodgkin's lymphoma (HL) survivors treated with abdominal radiotherapy and/or procarbazine have an increased risk of developing colorectal neoplasia. AIMS: We evaluated the clinicopathological characteristics and risk factors for developing (advanced) neoplasia (AN) in HL survivors. METHODS: In all, 101 HL survivors (median age 51 years, median age of HL diagnosis 25 years) underwent colonoscopy and 350 neoplasia and 44 AN (classified as advanced adenomas/serrated lesions or colorectal cancer), mostly right-sided, were detected, as published previously. An average-risk asymptomatic cohort who underwent screening colonoscopy were controls (median age 60 years). Clinicopathological characteristics of AN were evaluated in both groups. Mismatch repair (MMR) status was assessed using immunohistochemistry (MLH1/MSH2/MSH6/PMS2). Logistic regression analysis was performed to evaluate the risk factors for AN in HL survivors, including age at HL diagnosis and interval between HL and colonoscopy. RESULTS: In 101 colonoscopies in HL survivors, AN was primarily classified based on polyp size ≥10 mm, whereas (high-grade)dysplasia was more often seen in AN in controls. An interval between HL diagnosis and colonoscopy >26 years was associated with more AN compared with an interval of <26 years, with an odds ratio for AN of 3.8 (95% confidence interval 1.4-9.1) (p < 0.01). All 39 AN that were assessed were MMR proficient. CONCLUSIONS: Colorectal neoplasia in HL survivors differ from average-risk controls; classification AN was primarily based on polyp size (≥10 mm) in HL survivors. Longer follow-up between HL diagnosis and colonoscopy was associated with a higher prevalence of AN in HL survivors.
Authors 21
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The Netherlands Cancer Institute
Affiliation as printed
Department of <sup>1</sup>Gastroenterology and Hepatology Netherlands Cancer Institute Amsterdam The Netherlands
Department of 1Gastroenterology and Hepatology Netherlands Cancer Institute Amsterdam The Netherlands
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The Netherlands Cancer Institute
Affiliation as printed
Department of <sup>1</sup>Gastroenterology and Hepatology Netherlands Cancer Institute Amsterdam The Netherlands
Department of 1Gastroenterology and Hepatology Netherlands Cancer Institute Amsterdam The Netherlands
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Affiliation as printed
Department of Gastroenterology and Hepatology Erasmus Medical Center University Hospital Rotterdam The Netherlands
Department of Gastroenterology and Hepatology, Erasmus Medical Center University Hospital, Rotterdam, The Netherlands
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University Medical Center Utrecht
Affiliation as printed
Department of Gastroenterology and Hepatology University Medical Center Utrecht Utrecht The Netherlands
Department of, Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center
Affiliation as printed
Department of Gastroenterology and Hepatology Radboud University Medical Center Nijmegen The Netherlands
Department of, Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
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The Netherlands Cancer Institute
Affiliation as printed
Department of Radiation Oncology Netherlands Cancer Institute Amsterdam The Netherlands
Department of, Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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Amsterdam University Medical Centers
Affiliation as printed
Department of Gastroenterology and Hepatology Amsterdam University Medical Centers Amsterdam The Netherlands
Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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The Netherlands Cancer Institute
Affiliation as printed
Department of <sup>1</sup>Gastroenterology and Hepatology Netherlands Cancer Institute Amsterdam The Netherlands
Department of 1Gastroenterology and Hepatology Netherlands Cancer Institute Amsterdam The Netherlands
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Affiliation as printed
Department of Gastroenterology and Hepatology Erasmus Medical Center University Hospital Rotterdam The Netherlands
Department of Gastroenterology and Hepatology, Erasmus Medical Center University Hospital, Rotterdam, The Netherlands
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The Netherlands Cancer Institute
Affiliation as printed
Department of Medical Oncology Netherlands Cancer Institute Amsterdam The Netherlands
Department of, Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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Affiliation as printed
Department of <sup>8</sup>Hematology Erasmus MC Cancer Institute Rotterdam The Netherlands
Department of 8Hematology Erasmus MC Cancer Institute Rotterdam The Netherlands
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Affiliation as printed
Department of Radiation Oncology Erasmus MC Cancer Institute Rotterdam The Netherlands
Department of, Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
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University Medical Center Utrecht
Affiliation as printed
Department of Hematology University Medical Center Utrecht Utrecht The Netherlands
Department of, Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
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University Medical Center Utrecht
Affiliation as printed
Department of Radiation Oncology University Medical Center Utrecht Utrecht The Netherlands
Department of, Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center
Affiliation as printed
Department of Radiation Oncology Radboud University Medical Center Nijmegen The Netherlands
Department of, Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
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The Netherlands Cancer Institute
Affiliation as printed
Department of Pathology Netherlands Cancer Institute Amsterdam The Netherlands
Department of, Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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The Netherlands Cancer Institute
Affiliation as printed
Department of Epidemiology Netherlands Cancer Institute Amsterdam The Netherlands
Department of, Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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The Netherlands Cancer Institute
Affiliation as printed
Department of Epidemiology Netherlands Cancer Institute Amsterdam The Netherlands
Department of, Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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The Netherlands Cancer Institute
Affiliation as printed
Department of Pathology Netherlands Cancer Institute Amsterdam The Netherlands
Department of, Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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The Netherlands Cancer Institute
Affiliation as printed
Department of Pathology Netherlands Cancer Institute Amsterdam The Netherlands
Department of, Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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Monique Esther van Leerdam corresponding Aachen Department of Gastroenterology and Hepatology Leiden University Medical Center Leiden The Netherlands Department of Gastroenterology and Hepatology
Leiden University Medical Center · The Netherlands Cancer Institute
Affiliation as printed
Department of <sup>1</sup>Gastroenterology and Hepatology Netherlands Cancer Institute Amsterdam The Netherlands
Department of Gastroenterology and Hepatology Leiden University Medical Center Leiden The Netherlands
Department of 1Gastroenterology and Hepatology Netherlands Cancer Institute Amsterdam The Netherlands
Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
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