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Related Experiment Videos

Treatment of malignant polyps

P Spinelli1, P Pizzetti, P Sala

  • 1Istituto Nazionale per lo Studio e la Cura dei Tumori-Milan, Italy.

Tumori
|May 1, 1995
PubMed
Summary

Endoscopic removal of malignant colorectal adenomas is effective, with high long-term survival rates. Careful patient selection based on histopathology is crucial for successful endoscopic treatment outcomes.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Colorectal Surgery

Background:

  • Malignant adenomas of the colon-rectum pose a significant clinical challenge.
  • Endoscopic removal is a potential alternative to surgical resection for select cases.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of endoscopic removal for malignant colorectal adenomas.
  • To assess the adequacy criteria for endoscopic treatment and their predictive values.

Main Methods:

  • Retrospective analysis of 191 malignant colorectal adenomas treated endoscopically between 1975 and 1993.
  • Evaluation of treatment adequacy based on histopathologic criteria.
  • Comparison of outcomes between patients treated endoscopically alone versus those undergoing subsequent surgical resection.

Main Results:

  • Endoscopic treatment was deemed adequate in 53% of cases.
  • High negative predictive value (96%) and low positive predictive value (32%) for adequacy criteria.
  • Actuarial survival for endoscopically treated patients was 97% at 5 years and 95% at 10 years.

Conclusions:

  • Endoscopic polypectomy can be a safe and effective treatment for malignant colorectal adenomas when appropriate criteria are met.
  • The adopted criteria for endoscopic treatment adequacy demonstrate high reliability in ruling out residual disease.
  • Long-term survival rates for patients treated solely with endoscopy are excellent, supporting its role in selected cases.

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