Treatment of rectal and colonic polyps showing early malignant change

Summary

The entire experience of the Lahey Clinic with adenocarcinoma and benign mucosal polyps of the colon and rectum with early malignant change for nine years from 1945 to 1954 is reported. Thirty-one per cent of the patients with benign mucosal polyps showing early malignant change were treated conservatively and there was no further difficulty.

We recognize that the complete story of the origin and development of rectal and colonic cancer has not been told. In our experience, many benign mucosal polyps of the rectum showing early cancer histologically can be treated safely by conservative methods. Polyps showing definite invasion of the stalk or adjacent bowel wall should be treated radically.

We are not in complete agreement with the recent report by Spratt, Ackerman and Moyer that there is no evidence to support the view that there is an intimate relationship between benign mucosal polyps and cancer. Until there is further evidence to the contrary, we believe that benign mucosal polyps of the colon and rectum have a malignant potential and should be removed or destroyed when discovered. We recognize, however, that there is need for further clinical and especially pathologic study of this problem.