Malignant colonic adenomas. Therapeutic criteria. Long-term results of therapy in a series of 42 patients in our healthcare area
Rev. esp. enferm. dig
; 101(12): 830-836, dic. 2009. tab, ilus
Article
en En
| IBECS
| ID: ibc-78175
Biblioteca responsable:
ES1.1
Ubicación: BNCS
ABSTRACT
Objective: a) to evaluate the appropriateness of histological criteria as proposed by Morson as indicators for surgery; and b) to compare the adequacy of Morsons criteria with Haggitts levels as indicators for surgery in the case of malignant sessile lesions. Material and methods: we carried out a prospective, protocolized study of 42 patients with polyps with invasive carcinoma (IC) who underwent colonoscopic polypectomy from 1979 through 2008. We applied the histological criteria proposed by Morson to all the patients included in the series. Results: we treated 24 polyps with IC and favorable histological criteria (FC) and 18 polyps showing unfavorable histological criteria (UC). All polyps with FC were treated by means of colonoscopic polypectomy. None of the patients showed signs of disease after a mean follow-up period o f 9.67 yrs. Patients with polyps with UC were recommended to undergo surgery. The presence of unfavorable histological criteria in the polypectomy sample was clearly associated with an unfavorable patient outcome and showed a 100% sensitivity level, a negative prognostic value (NPV) of 100%, and a false negative (FN) percentage of 0% for the prognosis of the disease. We found 12 sessile polyps (Haggitts level 4). Colonoscopic polypectomy was the treatment employed in 9 out of 12 cases. All patients are free from disease (mean follow- up 7.3 yrs). If Haggitts level criteria had been applied, all 12 patients would have undergone surgery. This means 58% more patients than following Morsons criteria. Conclusions: Morsons criteria are considered an adequate diagnostic tool for the indication of surgery in patients with malignant adenomas. Haggitts invasion levels do not accurately discriminate the necessity for surgery in case of malignant sessile lesions(AU)
Texto completo:
1
Colección:
06-national
/
ES
Base de datos:
IBECS
Asunto principal:
Adenoma
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Pólipos del Colon
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Colectomía
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Neoplasias del Colon
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Endoscopía
Tipo de estudio:
Guideline
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Male
Idioma:
En
Revista:
Rev. esp. enferm. dig
Año:
2009
Tipo del documento:
Article