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Diseases of the Colon & Rectum
Published in: Diseases of the Colon & Rectum 8/2005

01-08-2005 | Original Contributions

Histologic Risk Factors and Clinical Outcome in Colorectal Malignant Polyp: A Pooled-Data Analysis

Authors: Cesare Hassan, M.D., Angelo Zullo, M.D., Mauro Risio, M.D., Francesco P. Rossini, M.D., Sergio Morini, M.D.

Published in: Diseases of the Colon & Rectum | Issue 8/2005

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PURPOSE

The malignant polyp carries a significant risk of lymphohematic metastasis and mortality. Clinical usefulness of histologic risk factors is still controversial. The study was designed to compute the association between the main histologic risk factors and the occurrence of unfavorable outcomes in patients with malignant polyps.

METHODS

A MEDLINE search regarding malignant polyps was performed. Three histologic risk factors (positive resection margin, poor differentiation of carcinoma, vascular invasion) and five (residual disease, recurrent disease, lymph node metastasis, hematogenous metastasis, mortality) unfavorable clinical outcomes were evaluated. Further analysis was performed by subgrouping polyps in high-risk and low-risk groups.

RESULTS

Thirty-one studies enrolling 1,900 patients with malignant polyp were selected. Positivity of resection margin was significantly predictive of the presence of residual disease (odds ratio, 22; P < 0.0001), poorly differentiated carcinoma was associated with an increased mortality (odds ratio, 9.2; P < 0.05), and vascular invasion with a higher lymph node metastasis risk (odds ratio, 7; P < 0.05). Patients with high-risk polyps showed a significantly worse outcome than those with low-risk, especially for mortality (odds ratio, 11; P < 0.05). Surgical-related death was as low as 0.8 percent.

CONCLUSIONS

All three histologic risk factors are significantly associated with the clinical outcome. Classification in low-risk and high-risk patients may be regarded as a meaningful staging procedure.
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Metadata
Title
Histologic Risk Factors and Clinical Outcome in Colorectal Malignant Polyp: A Pooled-Data Analysis
Authors
Cesare Hassan, M.D.
Angelo Zullo, M.D.
Mauro Risio, M.D.
Francesco P. Rossini, M.D.
Sergio Morini, M.D.
Publication date
01-08-2005
Publisher
Springer-Verlag
Published in
Diseases of the Colon & Rectum / Issue 8/2005
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI
https://doi.org/10.1007/s10350-005-0063-3

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