A285 PREDICTORS FOR LOCAL RECURRENCE POST-ENDOSCOPIC MUCOSAL RESECTION(EMR) OF COLONIC LESION WITH 3CM IN SIZE OR MORE
Bibliographic record
Abstract
Colorectal cancer (CRC) is the second most common cause of death in Canada amongst all cancer deaths. Colonoscopy and polypectomy are effective in reducing the incidence of colorectal cancer and CRC-related mortality. Large lesions are challenging to remove endoscopically, and surgery is the primary management technique in most centers especially if the lesion is 3 cm or more. Endoscopic mucosal resection EMR is a minimally invasive procedure for removal of large polyps.It has high success rates and minimal morbidity and mortality, but outcome studies have not shown enough evidence of that because only a few studies are available for the large lesion >3cm To evaluate the predictors that’ll increase the recurrence rate post EMR of colonic lesion of 3 cm in size or more and to define the best time to repeat the colonoscopy post resection to detect the recurrence as early as possible to decrease the likely hood of surgical intervention which will reduce the mortality and morbidity A retrospective study, chart review, we recruit 100 patients who had a colonoscopy with EMR of colonic lesion of 3 cm in size or more between January 2010 and January 2016. Clinical data will be collected (age, size of the polyp, location, shape(flat or sessile), Histology, Follow-up colonoscopy in 3–6 month and presence of recurrence at that time, Follow-up colonoscopy in 6–18 month and presence of recurrence ta that time, using APC or clipping)will be determined from a retrospective chart review Overall recurrence was 16 cases (16%) (Recurrence detected between 3–6 months was 9%, Recurrence detected between 6–18 months was 8%), out of this 16 recurrent cases: 9 polyps were flat vs 7 were sessile, 8 polyps were in Right colon, 2 in Left,2 in Transverse,4 in Rectum, APC was used in 9 of the recurrent polyps, clips were used in 9 cases, 3 polyps were Tubular Adenoma with LGD, 7 were Tubulovillous (TV)Adenoma with LGD, 2 were TV Adenoma HGD, 8 were SSA,1 was TSA and 1 was Adenocarcinoma Based on our result, having a Flat polyp, polyps in Rt colon, Tubulovillous Adenoma with LGD or SSA will increase the risk of the recurrence rate and we recommend repeating the colonoscopy within 3 to 6 month if any of this predictor was found.Using APC or clips will not affect the recurrence rate, although the sample size was low as well as the recurrence rate the but this kind of procedure is not that common especially with a large polyp size None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".