Management and outcome of patients with invasive carcinoma arising in colorectal polyps

Emily E. Volk, John R. Goldblum, Robert E. Petras, William D. Carey, Victor W. Fazio

Research output: Contribution to journalArticle

182 Scopus citations

Abstract

Background & Aims: Treatment for invasive adenocarcinoma in colorectal polyps (malignant polyps) is controversial. The aim of this study was to evaluate our institutional treatment strategy for malignant polyps. Methods: Malignant polyps were designated as having favorable histology (grade I or II carcinoma with at least a 2-mm free margin) or unfavorable histology (grade III invasive adenocarcinoma, invasive adenocarcinoma with an unassessable margin, or a margin of <2 mm). Malignant polyps with favorable histology were considered treated adequately by endoscopic polypectomy, whereas further therapy was recommended for malignant polyps with unfavorable histology. Recurrence, residual adenocarcinoma in a follow-up resection specimen, or metastasis during follow-up were considered adverse outcomes. Results: Of the 47 patients identified, 17 (36%) had favorable histology. Sixteen patients (94%) were treated with polypectomy alone. None had an adverse outcome (median follow-up, 70 months). Thirty patients (64%) had unfavorable histology, and 21 patients (70%) underwent colectomy. Five patients underwent radiation therapy alone. Four patients underwent no additional therapy. Ten of 30 patients with unfavorable histology had adverse outcomes that differed significantly from the favorable histology group (P = 0.03). Conclusions: Endoscopic polypectomy alone is adequate therapy for malignant polyps with favorable histology.

Original languageEnglish (US)
Pages (from-to)1801-1807
Number of pages7
JournalGastroenterology
Volume109
Issue number6
DOIs
StatePublished - Dec 1995
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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