TY - JOUR
T1 - Conservative management of malignant colorectal polyps in select cases is safe in long-term follow-up
T2 - An institutional review
AU - Affi Koprowski, Marina
AU - Sutton, Thomas L.
AU - Brinkerhoff, Brian T.
AU - Chen, Emerson Y.
AU - Nabavizadeh, Nima
AU - Tsikitis, Vassiliki Liana
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/8
Y1 - 2022/8
N2 - Background: Non-operative management of early-stage polypectomy-identified colorectal cancer (CRC) may be a safe alternative, but limited data exist. Methods: We compared outcomes between adults with post-polypectomy CRC who did and did not ultimately undergo resection from 2003 to 2018. Overall (OS) and recurrence-free (RFS) survival were calculated via log rank analysis using the Mantel-Cox method and plotted on Kaplan-Meier curves with significance evaluated at P < 0.05. Results: N = 78 patients were included, most commonly with rectal/rectosigmoid CRC (45%). Almost half (47%) had resections, and the remaining 41 patients (53%) underwent organ-sparing techniques. Chemoradiation was administered to 5 of these 41 patients (12%), all with rectal cancer. At median follow-up of 52 months, 5-year OS and RFS were 78% and 100% with no significant differences when compared to resection (all P > 0.1). Discussion: Using evidence-based patient selection and adjuvant therapy, organ-sparing management provides equal survival when compared to resection for post-polypectomy CRC.
AB - Background: Non-operative management of early-stage polypectomy-identified colorectal cancer (CRC) may be a safe alternative, but limited data exist. Methods: We compared outcomes between adults with post-polypectomy CRC who did and did not ultimately undergo resection from 2003 to 2018. Overall (OS) and recurrence-free (RFS) survival were calculated via log rank analysis using the Mantel-Cox method and plotted on Kaplan-Meier curves with significance evaluated at P < 0.05. Results: N = 78 patients were included, most commonly with rectal/rectosigmoid CRC (45%). Almost half (47%) had resections, and the remaining 41 patients (53%) underwent organ-sparing techniques. Chemoradiation was administered to 5 of these 41 patients (12%), all with rectal cancer. At median follow-up of 52 months, 5-year OS and RFS were 78% and 100% with no significant differences when compared to resection (all P > 0.1). Discussion: Using evidence-based patient selection and adjuvant therapy, organ-sparing management provides equal survival when compared to resection for post-polypectomy CRC.
KW - Endoscopic resection
KW - Malignant colorectal polyps
KW - Non-operative
KW - Organ-sparing
KW - Transanal resection
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U2 - 10.1016/j.amjsurg.2022.02.059
DO - 10.1016/j.amjsurg.2022.02.059
M3 - Article
C2 - 35272851
AN - SCOPUS:85124997297
SN - 0002-9610
VL - 224
SP - 658
EP - 663
JO - American journal of surgery
JF - American journal of surgery
IS - 2
ER -