Epidemiology, management, and prognosis of malignant large bowel polyps within a defined population.

Chantereau, M.J.; Faivre, Jean; Boutron, M C; Piard, F; Arveux, Patrick; Bedenne, Laurent; Hillon, Patrick

doi:10.1136/gut.33.2.259

Cited by 30 publications

(22 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, the proportion of cases whose largest adenoma was less than 1 cm in maximum diameter was 30% in the present study, in contrast to 66% in the study of Macquart-Moulin et al (1987). Therefore, our study should have had greater power to detect associations with large adenomas, which are the most likely to be associated with malignant changes (O'Brien et al, 1990;Gatteschi et al, 1991;Chantereau et al, 1992).…”

Section: Discussionmentioning

confidence: 49%

Colorectal adenomas and diet: a case-control study of subjects participating in the Nottingham faecal occult blood screening programme

Little

Logan²,

Hawtin³

et al. 1993

Br J Cancer

View full text Add to dashboard Cite

Summary Diets high in animal fat and protein and low in fibre and calcium are thought to be factors in the etiology of colorectal cancer. Intakes of these nutrients were determined in three groups participating in a randomised trial of faecal occult blood (FOB) screening. A diet history was obtained by interview from 147 patients with colorectal adenomas, 153 age and sex matched FOB-negative controls (a) and 176 FOB-positive controls without colorectal neoplasia (b). Unconditional logistic regression was used to estimate relative risks (RR) and 95% confidence limits (t) adjusted for age, sex and social class.After adjustment for total energy intake, no associations were found with total, saturated or monounsaturated fat, or calcium intake. For total fibre intake there were non-linear relationships with both control groups with the crude RR for highest quintiles of total fibre intake compared to the lowest being 0.6, although this pattern was no longer apparent after adjustment for energy intake with group (a). In comparison with group (b) cereal fibre intake showed a more consistent inverse relationship with adenoma prevalence with the RR for ascending quintiles of intake being 1.0, 0.7 (0.3-1.6), 0.5 (0.3-1.1), 0.7 (0.4-1.4) and 0.3 (0.1-0.6) (trend x2 = 8.80, p = 0.003). In comparison with group (a), the adjusted RR for the highest quintile of cereal fibre intake compared with the lowest was 0.6, but no clear trend was apparent. There was an unexpected positive relationship between adenomas and polyunsaturated fat intake with the RR for having an adenoma being 1.0, 2.8 (1.3-6.1), 1.6 (0.7-3.4), 3.5 (1.6-7.5) and 2.3 (1.1-5.0) for ascending quintiles of polyunsaturated fat intakes (trend x2 = 4.8, P = 0.03) in comparison with group (a) only.Our data, while providing no support for the role of dietary animal fat or protein, do support the protective role of dietary cereal fibre in the etiology of colorectal adenomas.High intakes of animal fat and protein (Wynder & Shigematsu, 1967;Drasar and Irving, 1973), and low intakes of fibre (Burkitt, 1971) and calcium (Newmark et al., 1984) have been postulated to increase the risk of colorectal cancer. However, the role of these nutrients has not been clarified in analytical epidemiological studies (Zaridze, 1983;Willett, 1989a (Paul & Southgate, 1978).In addition to the nutrients about which we had specific hypotheses, we considered total energy intake as an important potential confounder (Willett, 1989b, pp , the sources of protein and fibre, and the different types of fatty acid.We also asked subjects about the frequency of consumption of certain foods which might be markers of 'healthy Correspondence: J. Little,

show abstract

Section: Discussionmentioning

confidence: 49%

Colorectal adenomas and diet: a case-control study of subjects participating in the Nottingham faecal occult blood screening programme

Little

Logan²,

Hawtin³

et al. 1993

Br J Cancer

View full text Add to dashboard Cite

show abstract

“…In 23 series, [14][15][16][17][18][19][20][21][22][24][25][26][27]29,[31][32][33][34][35]38,[40][41][42] clinical or endoscopic follow-up data were available, ranging from 12 to 90 (median, 60) months, and accounting for 1,535 (80.1 percent) of the included polyps. Regarding endoscopic data, polyp site was clearly specified in 17 series, accounting for 1,461 polyps.…”

Section: Descriptive Analysismentioning

confidence: 99%

“…Death because of surgical complications, inferred from 28 studies, was reported in 8 (0.8 percent) of 951 operated patients. [12][13][14][15][16][17][18][19][20][21][24][25][26][27][28][29][30][31][32][33][34][36][37][38][39][40][41][42] …”

Section: Descriptive Analysismentioning

confidence: 99%

“…12,20,21,26,28,32,33,35 From 13 studies, it was apparent that the majority of patients with such a risk factor (56/60) underwent surgical resection compared with only 336 of the 739 without it (93.3 vs. 45.4 percent; P < 0.0001). 12,17,18,20,[26][27][28][29]33,37,38,41,42 In addition, patients with areas of poor differentiation had a substantially higher risk of both metastatic disease and cancer-related mortality compared with their counterparts (Table 1).…”

Section: Grade Of Differentiationmentioning

confidence: 99%

See 1 more Smart Citation

Histologic Risk Factors and Clinical Outcome in Colorectal Malignant Polyp: A Pooled-Data Analysis

Hassan

Zullo

Risio

et al. 2005

Diseases of the Colon &Amp; Rectum

196

186

View full text Add to dashboard Cite

PURPOSE:The malignant polyp carries a significant risk of lymphohematic metastasis and mortality. Clinical usefulness of histologic risk factors is still controversial. The study was designed to compute the association between the main histologic risk factors and the occurrence of unfavorable outcomes in patients with malignant polyps. METHODS: A MEDLINE search regarding malignant polyps was performed. Three histologic risk factors (positive resection margin, poor differentiation of carcinoma, vascular invasion) and five (residual disease, recurrent disease, lymph node metastasis, hematogenous metastasis, mortality) unfavorable clinical outcomes were evaluated. Further analysis was performed by subgrouping polyps in high-risk and lowrisk groups. RESULTS: Thirty-one studies enrolling 1,900 patients with malignant polyp were selected. Positivity of resection margin was significantly predictive of the presence of residual disease (odds ratio, 22; P < 0.0001), poorly differentiated carcinoma was associated with an increased mortality (odds ratio, 9.2; P < 0.05), and vascular invasion with a higher lymph node metastasis risk (odds ratio, 7; P < 0.05). Patients with high-risk polyps showed a significantly worse outcome than those with low-risk, especially for mortality (odds ratio, 11; P < 0.05). Surgical-related death was as low as 0.8 percent. CONCLUSIONS: All three histologic risk factors are significantly associated with the clinical outcome. Classification in low-risk and high-risk patients may be regarded as a meaningful staging procedure. T he malignant polyp, namely an adenoma containing a carcinoma invading the submucosa but not the muscular layer, represents the vast majority of early colorectal cancer, carrying a small but significant risk of both lymphohematic metastasis and mortality. 1

show abstract

“…The rate of detection of colorectal cancer in the early stage has increased in recent years as a result of improvements in endoscopic technology [1][2][3] and for this reason the number of endoscopists and pathologists has increased to examine submucosal invasive colorectal cancers (SICCs) that are endoscopically resected [4][5][6] . Complete endoscopic resection (ER) of intramucosal carcinoma is regarded as curative treatment since such lesions have been found to be associated with almost no risk of lymph node metastasis.…”

mentioning

confidence: 99%

The Lymphatic Infiltration Identified by D2-40 Monoclonal Antibody Predicts Lymph Node Metastasis in Submucosal Invasive Colorectal Cancer

Kawaura

Fujii²,

Murata³

et al. 2007

Pathobiology

View full text Add to dashboard Cite

Background and Study Aims: Lymphatic infiltration has been recognized as a significant risk factor for lymph node metastasis of submucosal invasive colorectal cancer (SICC), but it is difficult to detect microscopically on hematoxylin and eosin (H&E)-stained slides. We therefore identified lymphatic infiltration of tumor cells with D2-40 monoclonal antibody, which reacts specifically against the endothelium of lymphatic vessels, to make an objective and precise diagnosis. Patients and Methods: The surgical specimens of 122 consecutive patients with nonpedunculated SICC were examined for lymphatic infiltration by immunohistochemical staining with D2-40 monoclonal antibody (LI-D) and for venous infiltration by Elastica van Gieson staining (VI-E). Results: Lymph node metastasis was found in 20 patients. Multivariate analysis showed that LI-D (p = 0.0415) and VI-E (p = 0.0119) were significant risk factors for lymph node metastasis. Regardless of the presence of risk factors including at least either lymphatic infiltration or venous infiltration, no lymph node metastasis-positive patients were found (0%) among the 25 patients whose colorectal cancer had a submucosal invasive depth of less than 1,500 µm. No lymph node metastasis was found in any of the patients with a depth of submucosal invasion of less than 3,000 µm, who had no risk factors, including LI-D or VI-E. Conclusions: Correct evaluation of lymphatic infiltration by immunohistochemical staining with D2-40 monoclonal antibody may play a crucial role in determining whether there are indications for additional treatment in the management of endoscopically resected SICC.

show abstract

Epidemiology, management, and prognosis of malignant large bowel polyps within a defined population.

Cited by 30 publications

References 10 publications

Colorectal adenomas and diet: a case-control study of subjects participating in the Nottingham faecal occult blood screening programme

Colorectal adenomas and diet: a case-control study of subjects participating in the Nottingham faecal occult blood screening programme

Histologic Risk Factors and Clinical Outcome in Colorectal Malignant Polyp: A Pooled-Data Analysis

The Lymphatic Infiltration Identified by D2-40 Monoclonal Antibody Predicts Lymph Node Metastasis in Submucosal Invasive Colorectal Cancer

Contact Info

Product

Resources

About