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The included patients had adenomas \u226510\u00a0mm, high\u2010grade dysplasia, villous component or \u22653 more adenomas at baseline and were scheduled to undergo surveillance colonoscopy at 3\u00a0years\u00a0\u00b1\u00a06\u00a0months. Somatic <jats:italic>KRAS<\/jats:italic> mutation was performed on 1189 polyps collected from these patients. At surveillance, advanced lesions were defined as adenomas with a size of \u226510\u00a0mm. High\u2010grade dysplasia or villous component, serrated polyps \u226510\u00a0mm or with dysplasia or CRC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, 81 patients (15.6%) had <jats:italic>KRAS<\/jats:italic> mutations in at least one polyp. Patients with <jats:italic>KRAS<\/jats:italic> mutated polyps had more frequent villous histological lesions and size \u226520\u00a0mm. In the multivariate analysis, adjusted for age and sex, only age (odds ratios [OR], 1.06; 95% confidence interval [CI], 1.02\u20131.09; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), \u22655 adenomas (OR, 3.92; 95% CI, 1.96\u20137.82), and <jats:italic>KRAS<\/jats:italic> mutation (OR, 2.54; 95% CI, 1.48\u20134.34; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) were independently associated with the development of advanced lesions at surveillance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results show that, in patients with high\u2010risk adenomas, the presence of somatic mutations in <jats:italic>KRAS<\/jats:italic> is an independent risk factor for the development of advanced metachronous polyps.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12667","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T06:39:58Z","timestamp":1728887998000},"page":"1179-1189","source":"Crossref","is-referenced-by-count":1,"title":["Prediction of metachronous advanced colorectal neoplasia by <i>KRAS<\/i> mutation in polyps"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8337-4133","authenticated-orcid":false,"given":"Alejandro","family":"Mart\u00ednez\u2010Roca","sequence":"first","affiliation":[{"name":"Servicio de Medicina Digestiva Instituto de Investigaci\u00f3n Sanitaria ISABIAL Hospital General Universitario Dr. Balmis  Alicante Spain"},{"name":"Departamento de Medicina Cl\u00ednica Universidad Miguel Hern\u00e1ndez  Alicante 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