Long-term prognosis of well-differentiated adenocarcinoma in endoscopically removed colorectal adenomas

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.

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

“…2,3,10,11,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Overall, 133 patients (11 percent) had an adverse outcome. None of these patients fulfilled our low-risk criteria (Table 3).…”

Risk factor assessment of endoscopically removed malignant colorectal polyps

“…This was found in eight polyps (11.4%), six of which (75%) had an adverse outcome; this emphasises the importance to the histologist of the gastroenterologist’s polypectomy report, as it is well accepted that such patients need surgery 28 9 12 15 As the detailed histological features could not be reliably determined, we excluded incompletely removed polyps from further histological risk assessment.…”

The Clinical and Endoscopic Characteristics, Treatment, and Long-Term Prognosis of Early Colorectal Cancer in Taiwan

“…Endoscopic treatment for early CRC is a safe, effective, and relatively minimal invasive choice of treatment consistently observed in our study and others_. 19,20 Although several reports indicated that early CRC limited in the mucosal layer tended not to metastasize and treatment by endoscopic removal is generally deemed sufficient, 3,19-22 1 percent of the cases in the literature had a residual, recurrent, or even metastasis outcome. 19,23 From our experience, early CRC still has the possibility of metastasis without local recurrence after a longer follow-up period.…”