Abstract
Thirty-six malignant polyps were identified that met the following criteria: well-differentiated adenocarcinoma and complete excision endoscopically. Location, type, size, distance of the cancer to the cautery mark, and lymphovascular involvement were analyzed to determine if they affected findings at surgery or risk of recurrent cancer. There were 20 patients and 21 polyps in the nonsurgical group, and 15 patients and polyps in the surgical group. One patient from each group had residual cancer after endoscopic removal of the polyp. The only factor that had an adverse effect on outcome was the distance of the cancer to the cautery mark (<1 mm). Although rectal location was associated with the residual cancer, poor prognosis could have been predicted by the inadequate margins. This long-term follow-up (65 months average) study supports previous observations that an adequate margin is the most important factor in predicting the prognosis of endoscopically resected colorectal adenomas containing well-differentiated adenocarcinomas.
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Colacchio TA, Forde KA, Scantlebury VP: Endoscopic polypectomy—inadequate treatment for invasive colorectal carcinoma. Ann Surg 194:704–707, 1981
Morson BC, Whiteway JE, Jones EA, Macrae FA, Williams CB: Histopathology and prognosis of malignant colorectal polyps treated by endoscopic polypectomy. Gut 25:437–444, 1984
Lipper S, Kahn LB, Ackerman LV: The significance of microscopic invasive cancer in endoscopically removed polyps of the large bowel. Cancer 52:1691–1699, 1983
Langer JC, Cohen Z, Taylor BR, Stafford S, Jeejeebhoy KN, Cullen JB: Management of patients with polyps containing malignancy removed by colonoscopic polypectomy. Dis Colon Rectum 27:6–9, 1984
Fried GM, Hreno A, Duguid WP, Hampson LG: Rational management of malignant colon polyps based on long-term follow-up. Surg 96:815–820, 1984
Fucini C, Wolff BG, Spencer RJ: An appraisal of endoscopic removal of malignant colonic polyps. Mayo Clin Proc 61:123–126, 1986
Pollard CW, Nivatvongs S, Rojanasakul A, Reiman HM, Dozois RR: The fate of patients following polypectomy alone for polyps containing invasive carcinoma. Dis Colon Rectum 35:933–937, 1992
Nivatvongs S, Rojanasukul A, Reiman HM, Dozois RR, Wolff BG, Pemberton JH, Beart RW, Jacques LF: The risk of lymph node metastasis in colorectal polyps with invasive adenocarcinoma. Dis Colon Rectum 34:323–328, 1991
Russell JB, Chu DZ, Russell P, Chan CH, Thompson C, Schaefer RF: When is polypectomy sufficient treatment for colorectal cancer in a polyp? Am J Surg 160:665–668, 1990
Cranley JP, Petras RE, Carey WD, Paradis K, Sivak M: When is polypectomy adequate therapy for colonic polyps containing invasive carcinoma? Gastroenterol 91:419–427, 1986
Sugihara K, Muto T, Morioka Y: Management of patients with invasive carcinoma removed by colonoscopic polypectomy. Dis Colon Rectum 32:829–834, 1989
Muller S, Chesner IM, Egan MJ, Rowlands DC, Collard MJ, Swarbrick ET, Newman J: Significance of venous and lymphatic invasion in malignant polyps of the colon and rectum. Gut 30:1385–1391, 1989
Coverlizza S, Risio M, Ferrari A, Fenoglio-Preiser CM, Rossini FP: Colorectal adenomas containing invasive carcinoma. Cancer 64:1937–1947, 1989
Christie JP: Malignant colon polyps—cure by colonoscopy or colectomy? Am J Gastroenterol 79:543–547, 1984
Haggitt RC, Glotzbach RE, Soffer EE, Wruble LD: Prognostic factors in colorectal carcinomas arising in adenomas: Implications for lesions removed by endoscopic polypectomy. Gastroenterology 89:328–336, 1985
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Cunningham, K.N., Mills, L.R., Schuman, B.M. et al. Long-term prognosis of well-differentiated adenocarcinoma in endoscopically removed colorectal adenomas. Digest Dis Sci 39, 2034–2037 (1994). https://doi.org/10.1007/BF02088143
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DOI: https://doi.org/10.1007/BF02088143