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01-11-2004 | Original Contributions

Is Endoscopic Polypectomy an Adequate Therapy for Malignant Colorectal Adenomas? Presentation of 114 Patients and Review of the Literature

Authors: U. Seitz, M.D., S. Bohnacker, M.D., S. Seewald, M.D., F. Thonke, M.D., B. Brand, M.D., T. Bräutigam, M.D., N. Soehendra, M.D.

Published in: Diseases of the Colon & Rectum | Issue 11/2004

PURPOSE

This study was designed to evaluate the outcome of endoscopic polypectomy of malignant polyps with and without subsequent surgery based on histologic criteria.

METHODS

Consecutive patients with invasive carcinoma in colorectal polyps endoscopically removed between 1985 and 1996 were retrospectively studied. Patients with complete resection, grading G1 or G2, and absence of vascular invasion were classified as “low risk.” The other patients were classified “high risk.” Available literature was reviewed by applying similar classification criteria.

RESULTS

A total of 114 patients (59 males; median age, 70 (range, 20–92) years) were included. Median polyp size was 2.5 (0.4–10) cm. After polypectomy, of 54 patients with low-risk malignant polyps, 13 died of unrelated causes after a median of 76 months, 5 had no residual tumor at surgery, and 33 were alive and well during a median follow-up of 69 (range, 9–169) months. Of 60 patients with high-risk malignant polyps, 52 had surgery (residual carcinoma 27 percent). Five of eight patients not operated had an uneventful follow-up of median 57 (range, 47-129) months. Patients in the high-risk group were significantly more likely to have an adverse outcome than those in the low-risk group (P < 0.0001). Review of 20 studies including 1,220 patients with malignant polyps revealed no patient with low-risk criteria with an adverse outcome.

CONCLUSIONS

For patients with low-risk malignant polyps, endoscopic polypectomy alone seems to be adequate. In high-risk patients, the risk of adverse outcome should be weighed against the risk of surgery.

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Title: Is Endoscopic Polypectomy an Adequate Therapy for Malignant Colorectal Adenomas? Presentation of 114 Patients and Review of the Literature
Authors: U. Seitz, M.D.
S. Bohnacker, M.D.
S. Seewald, M.D.
F. Thonke, M.D.
B. Brand, M.D.
T. Bräutigam, M.D.
N. Soehendra, M.D.
Publication date: 01-11-2004
Publisher: Springer-Verlag
Published in: Diseases of the Colon & Rectum / Issue 11/2004
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI: https://doi.org/10.1007/s10350-004-0680-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Is Endoscopic Polypectomy an Adequate Therapy for Malignant Colorectal Adenomas? Presentation of 114 Patients and Review of the Literature

PURPOSE

METHODS

RESULTS

CONCLUSIONS

Keynote webinar | Spotlight on medication adherence

Springer Medicine

PURPOSE

METHODS

RESULTS

CONCLUSIONS

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