Is endoscopic polypectomy an adequate therapy for malignant colorectal adenomas?
PURPOSE: This study was designed to evaluate the outcome of endoscopic polypectomy of malignant polyps with and without subsequent surgery based on histologic criteria. METHODS: Consecutive patients with invasive carcinoma in colorectal polyps endoscopically removed between 1985 and 1996 were retrospectively studied. Patients with complete resection, grading G1 or G2, and absence of vascular invasion were classified as “low risk.” The other patients were classified “high risk.” Available literature was reviewed by applying similar classification criteria. RESULTS: A total of 114 patients (59 males; median age, 70 (range, 20-92) years) were included. Median polyp size was 2.5 (0.4-10) cm. After polypectomy, of 54 patients with low-risk malignant polyps, 13 died of unrelated causes after a median of 76 months, 5 had no residual tumor at surgery, and 33 were alive and well during a median follow-up of 69 (range, 9-169) months. Of 60 patients with high-risk malignant polyps, 52 had surgery
