Zhang M, Yin R, Ying J, Liu GQ, Wang P, Ge JX. Risk factors and clinical prediction models for short-term recurrence after endoscopic surgery in patients with colorectal polyps. World J Gastrointest Surg 2025; 17(8): 109057 [DOI: 10.4240/wjgs.v17.i8.109057]
Corresponding Author of This Article
Jian-Xin Ge, Chief Physician, Department of Gastroenterology, Nanjing Jiangbei Hospital, No. 552 Geguan Road, Jiangbei New District, Nanjing 210048, Jiangsu Province, China. doc_gejianxin@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2025; 17(8): 109057 Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.109057
Risk factors and clinical prediction models for short-term recurrence after endoscopic surgery in patients with colorectal polyps
Meng Zhang, Rui Yin, Jie Ying, Guan-Qi Liu, Ping Wang, Jian-Xin Ge
Meng Zhang, Rui Yin, Jie Ying, Guan-Qi Liu, Ping Wang, Jian-Xin Ge, Department of Gastroenterology, Nanjing Jiangbei Hospital, Nanjing 210048, Jiangsu Province, China
Author contributions: Zhang M conceived and designed the study and wrote the manuscript; Ge JX conceived and designed the study and oversaw the data collection process; Yin R and Ying J contributed to the data analysis; and Liu GQ and Wang P collected the data and literature. Each author has read and approved the final version of the manuscript and agreed to be accountable for all aspects of the work, ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All the authors made significant contributions to the research and preparation of this manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Nanjing Jiangbei Hospital (Approval No. 2024040).
Informed consent statement: The need for patient consent was waived by the Ethics Committee due to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: The data used in this study can be obtained from the corresponding author upon request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Xin Ge, Chief Physician, Department of Gastroenterology, Nanjing Jiangbei Hospital, No. 552 Geguan Road, Jiangbei New District, Nanjing 210048, Jiangsu Province, China. doc_gejianxin@163.com
Received: May 14, 2025 Revised: June 17, 2025 Accepted: July 8, 2025 Published online: August 27, 2025 Processing time: 103 Days and 4.2 Hours
Abstract
BACKGROUND
Colorectal polyps (CPs) are important precursor lesions of colorectal cancer, and endoscopic surgery remains the primary treatment option. However, the short-term recurrence rate post-surgery is high, and the risk factors for recurrence remain unknown.
AIM
To comprehensively explore risk factors for short-term recurrence of CPs after endoscopic surgery and develop a nomogram prediction model.
METHODS
Overall, 362 patients who underwent endoscopic polypectomy between January 2022 and January 2024 at Nanjing Jiangbei Hospital were included. We screened basic demographic data, clinical and polyp characteristics, surgery-related information, and independent risk factors for CPs recurrence using univariate and multivariate logistic regression analyses. The multivariate analysis results were used to construct a nomogram prediction model, internally validated using Bootstrapping, with performance evaluated using area under the curve (AUC), calibration curve, and decision curve analysis.
RESULTS
CP re-occurred in 166 (45.86%) of the 362 patients within 1 year post-surgery. Multivariate logistic regression analysis showed that age (OR = 1.04, P = 0.002), alcohol consumption (OR = 2.07, P = 0.012), Helicobacter pylori infection (OR = 2.34, P < 0.001), polyp number > 2 (OR = 1.98, P = 0.005), sessile polyps (OR = 2.10, P = 0.006), and adenomatous pathological type (OR = 3.02, P < 0.001) were independent risk factors for post-surgery recurrence. The nomogram prediction model showed good discriminatory (AUC = 0.73) and calibrating power, and decision curve analysis showed that the model had good clinical benefit at risk probabilities > 20%.
CONCLUSION
We identified multiple independent risk factors for short-term recurrence after endoscopic surgery. The nomogram prediction model showed a certain degree of differentiation, calibration, and potential clinical applicability.
Core Tip: This retrospective study explored risk factors for short-term recurrence of colorectal polyps after endoscopic surgery and developed a nomogram prediction model. We identified key risk factors such as age, alcohol consumption, Helicobacter pylori infection, number of polyps, sessile polyps, and adenomatous pathology. A nomogram prediction model developed based on these factors showed good discriminatory and calibration abilities, offering clinicians a practical tool for individualized recurrence risk assessment to optimize treatment and follow-up strategies.
