Related Experiment Videos
Lymph node metastases from carcinomas developing in pedunculated and semipedunculated colorectal adenomas
The Australian and New Zealand Journal of Surgery
|October 1, 1981
Summary
Submucosal colorectal cancers found in polyps can spread to lymph nodes. Resection is recommended after endoscopic polypectomy if cancer invades deeply or is poorly differentiated.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Intramucosal carcinomas generally do not metastasize.
- Submucosal colorectal cancers carry a risk of lymph node involvement (5-10%).
- Some submucosal cancers arise in polyps amenable to endoscopic polypectomy.
Observation:
- A review of 214 endoscopically removed colorectal polyps (1976-1979) identified six with submucosal invasive carcinoma.
- All six patients underwent subsequent colon resection.
- Two of these patients had lymph node metastases.
Findings:
- Endoscopic polypectomy alone may be insufficient for certain submucosal colorectal cancers.
- Criteria for recommending further resection include carcinoma at the cut end, deep invasion, lymphatic involvement, or poorly differentiated histology.
Implications:
- This study highlights the importance of careful pathological assessment of endoscopically resected polyps.
- It underscores the need for surgical resection in high-risk cases to prevent metastasis.
- Adherence to these criteria can improve patient outcomes for submucosal colorectal cancers.