Follow-up of patients with colonic polyps containing severe atypia and invasive carcinoma. Compliance, recurrence, and survival

Abstract

Between January 1975 and December 1984 1769 polyps were endoscopically removed from 1219 patients. Eight percent of these patients had polyps containing severe atypia and 5.0% had polyps containing invasive cancer. A close postoperative surveillance program was followed by only a few patients, but compliance improved with longer follow-up intervals. Metachronous polyps were observed with similar frequency in patients with benign polyps (34.8%) and those with polyps containing severe atypia (23.8%) or cancer (41.7%). Patients in whom malignant polyps were endoscopically removed had a 5-year survival rate of 84.3% that did not differ from that of patients' whose polyps contained severe atypia (79.0%). It was concluded that endoscopic removal of malignant polyps with favorable histologic conditions does not impair survival. The follow-up program of these patients should be adapted to that of patients with benign polyps, a procedure that may even improve patient compliance.

The Malignant Polyp - When to Operate: The St. Mark’s Experience

“…By 1975 Wolff and Shinya (2), on the basis of the histopathological expertise of Riddell and Morson (J) and their already considerable experience of colonoscopic polypectomy, gave a 'seal of approval' co the principle of conservatism in the management of malignant polyps. Since then a large number of ocher clinical series have supported this approach (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), as have editorials (20,21) and review articles (15,22,23 ).…”

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).…”

Effective Screening for Bowel Cancer: A United Kingdom Perspective

“…[101][102][103][104] Vogelstein et al 105 have provided a genetic map, which underpins this hypothesis. There is also good evidence from cancer occurring in large polyps, 101,102 and that after incomplete removal of polyps, 18 there is an increased risk of cancer at that site.…”