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Management of Pt1 tumours removed by endoscopy during colorectal cancer screening: Outcome and treatment quality indicators.
Senore, Carlo; Giovo, Ilaria; Ribaldone, Davide Giuseppe; Ciancio, Alessia; Cassoni, Paola; Arrigoni, Arrigo; Fracchia, Mario; Silvani, Marco; Segnan, Nereo; Saracco, Giorgio Maria.
Afiliación
  • Senore C; Cancer Epidemiology Unit, CPO Piemonte, AOU Città della Salute e della Scienza, Turin, Italy.
  • Giovo I; Division of Gastroenterology, Department of Medical Sciences, Molinette Hospital, University of Turin, Italy.
  • Ribaldone DG; Division of Gastroenterology, Department of Medical Sciences, Molinette Hospital, University of Turin, Italy. Electronic address: davrib_1998@yahoo.com.
  • Ciancio A; Division of Gastroenterology, Department of Medical Sciences, Molinette Hospital, University of Turin, Italy.
  • Cassoni P; Pathology Unit, Department of Medical Sciences, Molinette Hospital, University of Turin, Italy.
  • Arrigoni A; Division of Gastroenterology, Department of Medical Sciences, Molinette Hospital, University of Turin, Italy.
  • Fracchia M; Division of Gastroenterology, Mauriziano Hospital, Turin, Italy.
  • Silvani M; Cancer Epidemiology Unit, CPO Piemonte, AOU Città della Salute e della Scienza, Turin, Italy.
  • Segnan N; Cancer Epidemiology Unit, CPO Piemonte, AOU Città della Salute e della Scienza, Turin, Italy.
  • Saracco GM; Division of Gastroenterology, Department of Medical Sciences, Molinette Hospital, University of Turin, Italy.
Eur J Surg Oncol ; 44(12): 1873-1879, 2018 12.
Article en En | MEDLINE | ID: mdl-30343994
INTRODUCTION: Limited information is available about outcomes of patients with malignant adenomas endoscopically resected at screening. The aim of the study was to evaluate diagnostic and therapeutic quality indicators and to correlate them with clinical and surgical outcomes. MATERIALS AND METHODS: We reviewed endoscopic and histology characteristics of all pT1 tumours endoscopically removed at the time of colonoscopy assessment in subjects with a positive screening test result in the context of a population-based program. RESULTS: 392 pT1 tumours were completely removed by endoscopy (en-bloc = 86.7%, piecemeal = 13.3%) and the histology report was considered complete in 83.2% of cases. Treatment was limited to endoscopic excision for 120 patients (30.7%, Group 1), 272 (69.3%, Group 2) underwent radicalisation surgery. In patients who had at least 1 lymph node examined, the rate of nodal involvement was 5.4% (13/239); no metastatic node was found in the 21 (27.6%) out of 76 patients with low-risk adenomas, who underwent surgery. CONCLUSION: Risk of nodal involvement in colorectal pT1 tumours is well predicted by known histologic features also in a screening setting, although it was lower than among patients from clinical series. Surgical overtreatment is still significantly present and there is ample room for improvement regarding diagnostic and therapeutic flow-chart.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Colonoscopía Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2018 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Colonoscopía Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2018 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido