Please use this identifier to cite or link to this item: http://hdl.handle.net/1822/28432

TitleOncological outcomes after endoscopic removal of malignant colorectal polyps
Author(s)Gonçalves, Bruno
Fontainhas, Vasco
Caetano, Ana Célia
Ferreira, Aníbal
Gonçalves, Raquel
Bastos, Pedro
Rolanda, Carla
KeywordsMalignant polyp
Postoperative complications
Residual
Risk factors
Submucosal invasion
Residual disease
Issue date2013
PublisherArán Ediciones, S.L.
JournalRevista Española de Enfermedades Digestivas
Abstract(s)Objective: malignant colorectal polyp, defined by submucosally invasive adenocarcinoma, is the earliest form of clinically relevant colorectal cancer (CRC). After endoscopic resection additional surgery may be necessary, although decision criteria remain debatable. The objective of this study was to assess oncologic outcomes in terms of locoregional disease and to identify areas of improvement that may facilitate patients´ management.Methods: retrospective study of 40 patients with T1 CRC endoscopically resected between 2007 and 2012. Clinicopathological features were assessed and correlated with residual disease (RD), defined as presence of adenocarcinoma in intestinal wall and/ or lymph nodes.Results: thirty-one patients underwent surgery while 9 were followed-up. After surgery, RD was confirmed in 15 (48.4 %) patients: 8 (53.3 %) wall disease, 5 (33 %) nodal metastasis, and 2 (13.3 %) with both. No recurrence was detected in the follow-up group. The characteristics of the lesions that were associated with DR were sessile configuration (p = 0.03), the degree of differentiation G3 (p = 0.01) and intercepted/indeterminate margins (p = 0.01). Twenty-two patients were operated because of inadequate evaluation, mainly due to piecemeal resection, and half of them were disease free. Postoperative complications were found in 9 (30 %) patients, mainly anastomotic leakage that was associated with rectum anterior resection (p = 0.03).Conclusions: surgery should be considered in the presence of any risk factor for residual disease, while follow-up can be offered in low risk settings. Was also demonstrated a clear need for technical improvement in endoscopic resection and pathology evaluation in order to prevent unnecessary surgeries.
TypeArticle
URIhttp://hdl.handle.net/1822/28432
DOI10.4321/S1130-01082013000800003
ISSN1130-0108
Publisher versionhttp://scielo.isciii.es/scielo.php/script_sci_serial/pid_1130-0108/lng_es/nr/lng_en
Peer-Reviewedyes
AccessOpen access
Appears in Collections:ICVS - Artigos em Revistas Internacionais com Referee

Files in This Item:
File Description SizeFormat 
goncalves bm_rev esp enferm dig 2013.pdf197,45 kBAdobe PDFView/Open

Partilhe no FacebookPartilhe no TwitterPartilhe no DeliciousPartilhe no LinkedInPartilhe no DiggAdicionar ao Google BookmarksPartilhe no MySpacePartilhe no Orkut
Exporte no formato BibTex mendeley Exporte no formato Endnote Adicione ao seu ORCID