Predicting Recurrence After Piecemeal Resection of Large, Lateral-Spreading Tumors

The Sydney EMR Recurrence Tool (SERT) is a prediction model for recurrence at follow-up after endoscopic mucosal resection (EMR) of large, lateral-spreading tumors. To develop the tool, researchers prospectively assessed 1178 lesions ≥20 mm in size at piecemeal EMR and first follow-up colonoscopy.

The overall rate of endoscopically detectable recurrence was 19.4%. Visible endoscopic recurrence had a negative predictive value of 99.2% and a positive predictive value of 66.1% based on histologic determination. Predictors of endoscopic recurrence were size ≥40 mm (odds ratio, 2.47), intraprocedural bleeding (OR, 1.78), and high-grade dysplasia (OR, 1.72); these predictors contributed 2 points, 1 point, and 1 point, respectively, to the cumulati…