title: Can the growth rate of a gallbladder polyp predict a neoplastic polyp?
abstract: OBJECTIVE
  The aim of this study was to evaluate whether the growth rate of a gallbladder (GB) polyp is a predictive indicator for neoplastic polyps.
  
  
  BACKGROUND
  Cholecystectomy for GB polyps that are larger than 10 mm is generally recommended because of the high probability of neoplasm. In contrast, a follow-up strategy is preferred for GB polyps smaller than 10 mm. However, there are no treatment guidelines for polyps that grow in size during the follow-up period.
  
  
  METHODS
  We retrospectively investigated 145 patients with GB polyps who underwent at least 1 ultrasonographic follow-up examination over an interval greater than 6 months, before cholecystectomy at Samsung medical center, South Korea, from 1994 to 2007. The growth rate was determined based on the change in size per time interval between 2 ultrasonographic examinations (mm/mo).
  
  
  RESULTS
  The median age of the patients was 48 years (range: 25 to 75). One hundred twenty-five non-neoplastic polyps and 20 neoplastic polyps were found. Neoplastic polyps were more frequently found in patients older than 60 years, those with hypertension, a polyp size greater than 10 mm, and a rapid growth rate greater than 0.6 mm/mo. On multivariate analysis, however, the growth rate was not related to the neoplastic nature of a polyp, but older age (>60 y) and large size (>10 mm) were significantly associated with neoplastic polyps.
  
  
  CONCLUSIONS
  Patient's age (>60 y) and large polyp size (>10 mm) were significant predictive factors for neoplastic GB polyps. GB polyps less than 10 mm in diameter do not require surgical intervention simply because they grow.
authors.affiliation: Departments of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Su Rin
authors.initials: SR
authors.lastname: Shin
authors.forename: Jong Kyun
authors.initials: JK
authors.lastname: Lee
authors.forename: Kwang Hyuck
authors.initials: KH
authors.lastname: Lee
authors.forename: Kyu Taek
authors.initials: KT
authors.lastname: Lee
authors.forename: Jong Chul
authors.initials: JC
authors.lastname: Rhee
authors.forename: Kee-Taek
authors.initials: KT
authors.lastname: Jang
authors.forename: Seong Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Choi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D002763:Cholecystectomy; D018450:Disease Progression; D005260:Female; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011127:Polyps / Q000601:surgery / Q000648:ultrastructure*; D011230:Precancerous Conditions / Q000000981:diagnostic imaging* / Q000601:surgery; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography