{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:51:49Z","timestamp":1791417109185,"version":"4.3.3"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Current guidelines recommend uniform 6-month surveillance after endoscopic mucosal resection (EMR) of large nonpedunculated colon polyps (LNPCPs). We aimed to develop and validate a risk stratification model to identify lesions at lower recurrence risk.<\/jats:p>\n                  <jats:p>This retrospective multicenter study utilizing prospectively maintained databases across 12 centers (2017\u20132024) evaluated LNPCPs \u226520 mm removed by hot EMR. Overall, 20 variables were included in multivariate Cox regression with stepwise selection to identify recurrence predictors. Validation was performed in a separate single-center cohort.<\/jats:p>\n                  <jats:p>The derivation cohort included 463 patients with 491 LNPCPs. Multivariate analysis identified four independent predictors: evidence of prior resection (hazard ratio [HR] 1.97, 95%CI 1.04\u20133.72; P = 0.03), absence of margin ablation (HR 1.96, 95%CI 1.22\u20133.23; P = 0.01), villous histology (HR 1.77, 95%CI 1.09\u20132.86; P = 0.02), and ileocecal valve (ICV) involvement (HR 2.66, 95%CI 1.29\u20135.45; P = 0.01). Validation in a separate cohort (169 patients, 187 polyps) demonstrated effective risk stratification performance (P &lt; 0.01). In the validation cohort, low-risk polyps (no prior resection, margin ablation performed, no villous histology, no ICV involvement) had recurrence risks of 2.2%, 5.4%, and 9.7% at 6, 12, and 18 months, respectively, compared with 10.6%, 23.1%, and 28.1% in high-risk polyps. No patients in either cohort developed high-grade dysplasia or invasive adenocarcinoma during follow-up.<\/jats:p>\n                  <jats:p>A simple four-factor model incorporating prior resection, margin ablation, villous histology, and ICV involvement stratified recurrence detection risk after hot EMR. Absence of high-risk features may help identify patients at lower recurrence risk and provides a framework for future prospective studies evaluating risk-adapted surveillance strategies.<\/jats:p>","DOI":"10.1055\/a-2955-8379","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T23:00:07Z","timestamp":1789513207000},"source":"Crossref","is-referenced-by-count":0,"title":["Risk stratification model for surveillance interval extension after hot endoscopic mucosal resection of large nonpedunculated colon polyps"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4613-6803","authenticated-orcid":false,"given":"Kanika","family":"Garg","sequence":"additional","affiliation":[{"name":"Rush University Medical Center, Illinois, United States","place":["Chicago"],"department":["Division of Digestive Diseases and Nutrition"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J","family":"Wang","sequence":"additional","affiliation":[{"name":"University of Southern California, California, United States","place":["Los Angeles"],"department":["Division of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Rush University Medical Center, Illinois, United States","place":["Chicago"],"department":["Division of Digestive Diseases and Nutrition"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Maniak","sequence":"additional","affiliation":[{"name":"Rush University Medical Center, Illinois, United States","place":["Chicago"],"department":["Division of Digestive Diseases and Nutrition"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal A","family":"Mehta","sequence":"additional","affiliation":[{"name":"Rush University Medical Center, Illinois, United States","place":["Chicago"],"department":["Division of Digestive Diseases and Nutrition"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher G","family":"Chapman","sequence":"additional","affiliation":[{"name":"Rush University Medical Center, Illinois, United States","place":["Chicago"],"department":["Division of Digestive Diseases and Nutrition"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Melson","sequence":"additional","affiliation":[{"name":"University of Arizona Medical Center - University Campus, Arizona, United States","place":["Tucson"],"department":["Division of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas K.","family":"Rex","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indiana, United States","place":["Indianapolis"],"department":["Division of Gastroenterology\/Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Guardiola","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indiana, United States","place":["Indianapolis"],"department":["Division of Gastroenterology\/Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0092-9496","authenticated-orcid":false,"given":"Douglas","family":"Pleskow","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center, Massachusetts, United States","place":["Boston"],"department":["Division of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6446-5785","authenticated-orcid":false,"given":"Michael B","family":"Wallace","sequence":"additional","affiliation":[{"name":"Mayo Clinic Jacksonville Campus, Florida, United States","place":["Jacksonville"],"department":["Division of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart R","family":"Gordon","sequence":"additional","affiliation":[{"name":"Dartmouth Hitchcock Medical Center, New Hampshire, United States","place":["Lebanon"],"department":["Section of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6125-0068","authenticated-orcid":false,"given":"Daniel","family":"von Renteln","sequence":"additional","affiliation":[{"name":"University of Montreal Hospital Centre, Canada","place":["Montreal"],"department":["Division of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouen A","family":"Khashab","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Maryland, United States","place":["Baltimore"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saowanee","family":"Ngamruengphong","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Maryland, United States","place":["Baltimore"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandar","family":"Gavri\u0107","sequence":"additional","affiliation":[{"name":"University Medical Centre Ljubljana, Slovenia","place":["Ljubljana"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3038-4669","authenticated-orcid":false,"given":"Dennis","family":"Yang","sequence":"additional","affiliation":[{"name":"AdventHealth Orlando, Florida, United States","place":["Orlando"],"department":["Center for Interventional 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